Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

Abstract

Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.

Horizontal Inequity in Healthcare Delivery: A Qualitative Analysis of Perceptions of Locality and Costs of Access in the Jirapa Municipality, North‐western Ghana

“…Hjortsberg and Mwikisa (2002) found in the case of Zambia (with similar health and demographic characteristics as Ghana) that the poor are less likely to seek healthcare when ill than the non‐poor and that distance to health facilities has an impact on utilisation, where nearly 50 per cent of people living less than 5 km from a health facility will seek healthcare when ill, compared with 17 per cent of people living more than 40 km from a health facility. Similar findings emerged in Ghana where transportation difficulties have been cited as a barrier to healthcare access in rural areas (Macha et al, 2012; Masters et al, 2013; Johnson et al, 2015; Nesbitt et al, 2016; Haruna, Dandeebo, & Galaa, 2019). Thus, whereas the relationship between transportation difficulties and limited access to healthcare has received research attention, the issues of costs relating to food and lodging during admissions have not been investigated in the specific context of the NHIS.…”

“…Cost of access remains a significant barrier to poor populations especially those in rural areas when they become ill and need to seek healthcare. Studies in developing countries (Hjortsberg & Mwikisa, 2002; Målqvist et al, 2010; Gabrysch, Cousens, Cox, & Campbell, 2011; Lohela, Campbell, & Gabrysch, 2012) including Ghana (Macha et al, 2012; Masters et al, 2013; Johnson et al, 2015; Nesbitt et al, 2016; Haruna et al, 2019) have shown that proximity to health facilities strongly influences healthcare use. In these contexts, however, distances to health facilities are often long, health‐related infrastructure is poor and a significant proportion of the population live in poverty.…”

Antenatal care and skilled delivery service utilisation in Somali pastoral communities of Eastern Ethiopia

“…Two‐thirds of maternal mortality in low and middle income countries occur due to direct obstetric complications . Antenatal care, skilled birth attendance at delivery and post‐natal care are critical ingredients in preventing maternal deaths . Despite this knowledge, in 2016 at national level, only 62% of women attended at least one antenatal care session, only 26 % of deliveries were assisted by a skilled birth attendant, and only 49% of women had their last birth protected against neonatal tetanus in Ethiopia .…”

Knowledge Attitude and Practice Regarding Maternal Health Care Services

“…This study shows that majority of the pregnant Female doctors more than two in OPD at RHC 100% females used government hospitals for antenatal care. A study conducted by Umar Haruna shows that utilization of antenatal care is increasing [9]. The current study shows that accessibility of maternal health services have many challenges in terms of quality of maternal health care, availability of maternal health care etc.…”