UTILISATION OF MATERNAL HEALTH SERVICES: THE CASE OF THE TALENSI/NABDAM DISTRICT

Abstract

Ghana has ratified the Millennium Development Goals, as part of which Ghana has a commitment to ensure universal access to skilled personnel for deliveries by 2015. Government over the last decade has instituted a number of policies and programmes to increase the utilisation of skilled attendants for delivery and to reduce maternal mortality. Notable among these interventions include the fee exemptions for maternal health services from the late nineties, the National Health Insurance Scheme and currently the free maternal health care policy. These policies have made progress; however progress has only improved marginally from 40% in 1988 to 59% in 2008 and at this rate of progress (GoGINDPC/UNDP, 2010). Ghana will not meet its target of achieving universal access to skilled attendants for delivery by 2015. The situation is even worse in the deprived areas of Ghana like the Upper East Region. For instance, in the Upper East Region of Ghana, the Talensi/Nabdam District still has a skilled delivery rate of 51% (GHS-TND,2010). This research had an objective "To investigate whether there are barriers to utilization of health facilities for Labour and Delivery in the Talensi/Nabdam District". The research used multi-stage sampling to create two primary units of Talensi and Nabdam speaking subdistricts. Simple random sampling was used to sample a sub-district out of each primary unit. Communities where research was carried out were purposively sampled. A Questionnaire was used to solicit information from women with children less than one year old. In all a sample size of 522 respondents were interviewed. Key informant interviews and focus group discussions was used to gather qualitative data. In all 46 opinion leaders participated in key informant interviews while four focus group discussions involving two women's and two men's groups were carried out. The results indicate that 65.5% of women in the study area agree that, cultural barriers to utilisation of skilled attendants for delivery do exist, while another 70.9% of women do also believe that socio-economic barriers do prevent women from utilising skilled attendants for delivery in the Talensi/Nabdam District. The research recommends community participation in planning and implementation of health interventions. Other recommendations include, Empowerment of women, establishment of effective ambulance systems, using Behaviour communication techniques to convince decision makers of households, and the encouragement of private participation in referral services.