Understanding the barriers to Ghanaian midwives’ ability to provide quality care: Using classic Grounded theory methodology in a new context

Abstract

Background: Interpretive-naturalist methodologies, including Grounded Theory are increasingly being used in health research in Ghana however, none of the studies that have used Grounded Theory in the setting has used the methodology in full. Aim: The main aim of this article is to describe the experiences, the strengths and limitations of using Glaserian Grounded Theory methodology to understand the barriers to Ghanaian midwives’ ability to provide quality maternal and neonatal care. Design: Glaserian Grounded Theory methodological principles were adhered to in this study in relation to the use of literature, participant recruitment, data collection and analysis, and theory development. Data were collected through semi-structured interviews and non-participant observation. The study population comprised 33 participants, made up of 29 midwives and four other workers whose work was relevant to the functioning of the midwives that took part in the study. The midwives were recruited from 10 health facilities in seven districts in the Greater Accra Region of Ghana. Glaserian Grounded Theory was used in this study therefore constant comparison was employed in the data analysis. Findings: The study led to the discovery of a middle range grounded theory – “Doing magic with very little”, that explains the factors that affect the midwives’ ability to provide quality care to women and neonates. Conclusion: This paper contributes to the body of work on methodological knowledge. We provide new information about the factors that researchers planning to use Glaserian Grounded Theory in similar contexts could consider.

Keywords

• Midwifery
• Quality health care
• Maternal health
• Neonatal health
• Grounded theory
• Ghana