Experiences of maternity care from women's and providers' perspectives in a peri-urban setting in Ghana

Obeng, JY

Abstract

The provision of quality maternity care is an important public health issue because a healthy
pregnancy can be the basis for a mother’s and child’s lifelong good health. However, the global
effort to reduce maternal and new-born mortality and morbidity in low-income settings hasfocused
on access to services and has tended to neglect aspects of care. In Ghana, a free maternal healthcare
delivery policy was introduced in 2008. Since then, the proportion of births that occurred without
skilled services reduced from 40% (2007) to 21% in (2018). One reason women may not be
accessing care is because they anticipate the treatment they receive as disrespectful or uncaring.
This study aims to explore the experiences and expectations of maternity care from both women’s
and providers’ perspectives.
Methods
A qualitative feminist approach was used in this study. A purposive sampling method was
employed to recruit 20 women who had given birth in the previous 12 months at the Tema General
Hospital (Tema Metropolitan District, Greater Accra Region, Ghana), and 10 maternity health
professionalsfrom the maternity ward. Semi-structured interviews were conducted between March
2018 and July 2018. Thematic analysis was used, and the data was interpreted within the context
of an existing quality of care framework produced by the World Health Organisation in 2018.
Results
Maternity healthcare providers reported poor working environments in the health facilities and
lack of recognition of their role, leading to feelings of demoralisation; this has contributed to the
healthcare users’ experiences of low quality and dehumanised care. Women revealed how much
religion impacted on their decision making; they described how they would consult pastors to
decide whether it was appropriate to go to the hospital, even when they were in labour. Both the
mothers and midwives are religious and referred to God in terms of whether things will go well.
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Women in labour lacked emotional support, experienced neglect, poor communication, as well as
physical and verbal abuse. One of the more blatant issues in the Ghanaian context was a dominant
discourse of the uncooperative woman, which served to allow midwives power and control over
women and their bodies, using punishment for non-compliance.
Limitation
The study does not represent the experiences of women who do not attend the hospital. However,
it may provide information regarding why some women may not wish or be able to attend the
hospital facilities.
Conclusion
Improving the respectful quality of maternity care in Ghana requires improving workers'
motivation, strengthening manpower resources and infrastructural development to ensure that
professionals can achieve pride in their work. More emphasis should be placed on religion and
women’s education when discussing countries that are dominated by beliefs and religion. The
failure to engage with this is likely to mean improvements /initiatives of positive maternity care
are likely to fail.
Keywords: Quality of maternity care, Intrapartum care, Respectful care, Women experiences,
Health facility.

Citation

Obeng, J. Experiences of maternity care from women's and providers' perspectives in a peri-urban setting in Ghana. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Nov 2, 2022
• Publicly Available Date: Nov 2, 2022
• Additional Information: Funders : GetFund
• Award Date: Jul 31, 2022