Access Opportunities, Social Structures and Maternal Health Seeking Behaviour in Bosomtwe District

Abstract

The study focuses on access opportunities to maternal health services in the rural Bosomtwe district in the Ashanti region which draws in other possible influences such as the structure of health service delivery system and social relations and to study health seeking behaviour to maternal health care. The objectives of the study are: first, to understand some of the considerations that influence the choice of these facilities for delivery care and identify facilities used for maternal health services and second, attempt to determine factors serving as barriers to maternal health services for women in the rural areas.

The study used a drawn sample from Kuntenase and Abono health zones in the Bosomtwe district with 16 women as primary informants. In addition key informants:midwives, trained TBAs and a medical director were interviewed. All informants were purposively sampled due to the qualitative information they could give. Semi-structured interviews, group discussions with the participants drawn from of the interviews were used to gather additional information.

The characteristics embedded in the maternal health care delivery system influence the attitude of both service providers and patients. The decisions of pregnant women with first birth experience are influenced by close social relations and social structures. However, the decisions of pregnant women with high parity are based on past experience and self-test experiments. The women are enabled to use maternal health services especially antenatal care with the introduction of the virtually free maternal care. Home births which are normally without professional supervision are practiced more widespread by women who live in the Abono than in Kuntenase health zones of the district. Pregnant women in Kuntenase use the hospital for both antenatal care and for birth. This not only widens the inequalities and health outcomes of women in the Abono and Kuntenase health zones but is also an example of distance decay and how supply of health services affects its use. There are overturning of important social structures like pregnant women crossing the lake to receive maternal care due to social changes and ‘modern’ ways of life. Barriers that discourage pregnant women from use of maternal health services are; distance, difficulty with referral from one level of care to another, auxiliary health care cost, perception and knowledge of health care.