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

Abstract

AbstractPlace 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