The use of antenatal care in two rural districts of Upper West Region, Ghana

Abstract

BackgroundDespite decades of implementation of maternity healthcare programmes, including a focus on increasing the use of antenatal care (ANC) and concomitant birth preparedness and complication readiness (BPCR), the uptake of ANC continues to be below expectations in many developing countries. This has attendant implications for maternal and infant morbidity and mortality rates. Known barriers to ANC use include cost, distance to health care services and forces of various socio-cultural beliefs and practices. As part of a larger study on BPCR in rural Ghana, this paper reflects on the use of ANC in the study areas from rights-based and maternal engagement theoretical perspectives, with a focus on the barriers to ANC use.MethodsMixed methods approach was adopted to collect data from 8 study communities from individual in-depth interviews with 80 expectant mothers and 13 health care professionals, and 24 focus groups comprising 240 community members. The qualitative data followed a thematic analytical method, while the quantitative data was analysed using descriptive statistics.ResultsThe average number of ANC visits were 3.34±1.292, and the majority of expectant mothers (71.3%) enrolled for ANC at the 8th week or later, with the longest delay recorded at the 6th month of gestation. Traditional norms significantly influenced this delay. Likewise, overall use of ANC during pregnancy was shaped by cultural factors related to perceptions of pregnancy, gender-based roles and responsibilities and concerns that ANC would result in an overweighed baby and culturally inappropriate delivery at a health care facility.ConclusionGreater understanding of the sociocultural barriers to ANC is essential if proposed changes in community-specific health education programs are to facilitate early commencement and increased use of ANC.

Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study

“…The difference across studies might be related with the utilization of antenatal care services across countries. For instance, a study conducted in Ghana indicated that a higher proportion of pregnant women were completed four or more antenatal care visits compared to a study conducted in Ethiopia (41.3% vs 33.0%) (46,47). Moreover, the risk of giving birth for a small newborn baby for gestational age among women with PIH was higher; this could be related with intrauterine growth retardation due to a decrease of uteroplacental blood flow and the development of ischemia in women with pregnancy-induced hypertension.…”

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

“…An estimated 99% of all maternal deaths occur in developing countries and more than half occur in sub-Saharan Africa (SSA) [1]. Developing countries continue to grapple with a huge burden of maternal and child mortalities where approximately 800 girls and women died as a result of pregnancy and childbirth-related complications in 2015 in SSA [2].…”

Factors Influencing Male Involvement in Antenatal Care in the Kassena Nankana Municipal in the Upper East Region, Ghana

“…The World Health Organization predicts a world where every pregnant woman and newborn receives quality care throughout the pregnancy, childbirth, and the postnatal period (WHO, 2016a). There is widespread evidence that antenatal care (ANC) is very crucial in the reduction of maternal mortality and morbidity (Miltenburg et al, 2017;Sumankuuro et al, 2017). The recommendations of World Health Organization (WHO) on maternal health care promotion interventions encourage active male partner involvement in ANC delivery as well as postnatal care to improve upon the health outcome of both mothers and their children (WHO, 2016a).…”