Knowledge of place of delivery and postnatal care among reproductive women in urban Ghana: a longitudinal qualitative study

Abstract

Place of delivery continues to be a burden to maternal healthcare despite the introduction of interventions and policies aimed to promote maternal health. Outcomes on the choice of place of delivery have not been captured using rigorous qualitative approaches, which are empirically proven. This study investigated the accounts of mothers who have delivered in the last five years either at home, or at health facilities, and evaluated the reasons for their choice of delivery in urban Ghana. The longitudinal case study design was employed using in-depth interviews and focus groups on women of reproductive age (15-49) in the pre- and post-COVID eras. The study investigated women’s opinions and experiences of care in terms of factors that influenced their place of delivery, service satisfaction, and whether they would recommend services to neighbours. Study results reveal that 2 out of 16 mothers delivered home and assisted by TBAs despite the introduction of the free maternal delivery in addition to other available interventions such as focused ANC aimed at improving maternal healthcare. Findings suggest that human-induced aspects of care during delivery are key to women’s expectations, which in turn build up satisfaction. Service improvements, which address aspects of care, are likely to have impact on health-seeking behaviour and utilisation.

Keywords:

• Delivery
• maternal health
• thematic analysis
• staff attitude
• TBA
• Ghana

REVIEWING EDITOR:

• Joe Thomas, Institute of Health and Management, Australia

SUBJECTS:

• Allied Health
• Breastfeeding
• Sexual & Reproductive Health
• Nursing
• Allied Health

Acknowledgments

The authors are grateful to the municipal health nurse, facility nurses, and midwives in selected facilities. They are also grateful to all the study participants for their support during the data collection. Lastly, they would like to thank the Kwabre East Municipal Health Directorate for both personnel and logistic support.

Disclosure statement

The authors declare that they have no competing interests.

Consent to publish

Not applicable.

Data availability statement

All data supporting findings are available upon request.

Additional information

Notes on contributors

Jones Asafo Akowuah

Jones Asafo Akowuah is an MPhil holder from the Department of Agricultural Economics, Agribusiness, and Extension, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Kwame B. Bour

Kwame B. Bour is a Ph.D. holder from the Kwame Nkrumah University of Science and Technology. He is an ardent lecturer in the Department of Built Environment, University of Environment and Sustainable Development, Somanya-Ghana.

Ama Antwiwaa Opuni

Ama Antwiwaa Opuni holds a Master’s degree in Public Health and is serving as the Chief Nursing & Midwifery Officer, at Ashanti Regional Health Directorate, Kumasi-Ghana.

Dina Sarpong

Dina Sarpong is a holder of B.Sc. Nursing and works as a Nursing Officer at the Maternal and Child care unit at the Municipal Hospital, Mamponteng, Kumasi-Ghana.

Roland Owusu Aboagye

Roland Owusu Aboagye holds a Master of Education degree from the Institute of Education; Department of Teacher Education, University of Cape Coast-Ghana.