Maternal mortality in Ghana: an exploration of partners’ perception about factors that contributed to their wife’s death

Abstract

Background: Many programmes were put in place internationally and locally to curtail the menace of maternal mortality, but little achievement has been made in certain parts of the world, particularly in sub-Saharan Africa. A number of literatures exist, which investigate into the predisposing factors of maternal mortality in Ghana, however, no published evidence as the time of conducting this study explore the perception of men with respect to maternal mortality. This study aims to explore the perceptions of men who have lost their wives about the factors that contributed to their wife’s death in Accra, Ghana.Methods: A qualitative phenomenological approach was adopted, using an in-depth semi-structured interview conducted via a phone call, which was recorded and transcribed. Ten men participated in the study. The data was analysed using narrative synthesis through identification of themes/sub-themes. Results: It was identified that physical, cultural and socio-economic factors were responsible for the death of men’s wives on the course of pregnancy. The major physical factors include direct causes of maternal mortality notably haemorrhage, delay in reaching health facility and delay from the health facility. The cultural factors mainly include seeking care from unskilled attendants and use of traditional preparations to aid delivery. Lastly, poor socio-economic status was blamed by majority of the participants, which impedes them from accessing quality care within shortest period of time. Conclusions: Men perceived factors predisposing to maternal mortality in Accra, Ghana were avoidable with quality health care services and improved access to the health facilities.

A qualitative study of community elders’ perceptions about the underutilization of formal maternal care and maternal death in rural Nigeria

“…Studies in rural and urban Nigeria reported that policymakers, elders and other community members perceived malaria or fever as the most common medical ailments leading to a maternal death [45, 49]. Policymakers and male partners in sub-Saharan Africa believed excessive bleeding was the most common direct cause of women’s maternal death [49, 50], which is similar to narratives about bleeding in this study. Non-medical reasons identified by elders in this study include unavailability of facility services, and poor awareness and negligence.…”

“…These reasons are related to non-medical determinants of maternal deaths identified in the literature, including social, economic, and cultural factors [45, 49, 51–54], as well as political factors, healthcare system coordination, health services provision, community contexts, and demographic characteristics [49, 55]. Delays in reaching health facilities, delays in receiving care, and poorly skilled health attendants were also held responsible for high maternal mortality rates [50, 54, 56]. A cross-sectional study in Nigeria reported that men blame women’s failure to use FP, emergency, antenatal, and delivery care services for their deaths [54].…”

“…Additionally, women’s uptake of native maternal care over facility-based care was cited as a reason for maternal mortality in Edo State. The uptake of native maternal care has been strongly associated with higher rates of maternal mortality and other poor maternal outcomes [49, 50, 57]. Non-professional attendants, namely TBAs, lack the basic knowledge and skills required for the adequate provision of evidence-based maternal care [58, 59].…”

Audit of documentation accompanying referred maternity cases to a referral hospital in northern Ghana: a mixed-methods study

“…The Ghana Health Service (GHS) has directed that all referrals be accompanied by fully completed referral forms [ 9 ]. This is essential in maternity cases considering the severity of issues that prompts maternal referrals, including haemorrhage and foetal distress [ 10 , 11 ]. Nearly all lower level facilities in Ghana refer maternal complications to higher levels of healthcare [ 12 ].…”