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|Title: ||How intra-familial decision-making affects women’s access to, and use of maternal healthcare services in Ghana: a qualitative study|
|Authors: ||Ganle, John Kuumuori|
Segbefia, Alexander Yao
Yeboah, Joseph Yaw
|Issue Date: ||2015|
|Publisher: ||BMC Pregnancy and Childbirth|
|Citation: ||BMC Pregnancy and Childbirth (2015) 15:173 DOI 10.1186/s12884-015-0590-4|
|Abstract: ||Background: There is some evidence to suggest that within the household, family and community settings, women
in sub-Saharan Africa often have limited autonomy and control over their reproductive health decisions. However,
there are few studies that examine how intra-familial decision-making power may affect women’s ability to access and
use maternal health services. The purpose of this paper is to examine how intra-familial decision-making affects
women’s ability to access and use maternal health services.
Methods: We conducted 12 focus group discussions and 81 individual interviews with a total of 185 expectant and
lactating mothers in six communities in Ghana. In addition, 20 key informant interviews were completed with
healthcare providers. Attride-Stirling’s thematic network analysis framework was used to analyse the data.
Results: Findings suggest that decision-making regarding access to and use of skilled maternal healthcare services is
strongly influenced by the values and opinions of husbands, mothers-in-law, traditional birth attendants and other
family and community members, more than those of individual childbearing women. In 49.2 %, 16.2 %, and 12.4 % of
cases in which women said they were unable to access maternal health services during their last pregnancy, husbands,
mothers-in-law, and husband plus mothers-in-law, respectively, made the decision. Women themselves were the final
decision-makers in only 2.7 % of the cases. The findings highlight how the goal of improving access to maternal
healthcare services can be undermined by women’s lack of decision-making autonomy through complex processes of
gender inequality, economic marginalisation, communal decision-making and social power.
Conclusion: Interventions to improve women’s use of maternity services should move beyond individual women to
target different stakeholders at multiple levels, including husbands and mothers-in-law.|
|Description: ||An article published by BMC Pregnancy and Childbirth (2015) 15:173
|Appears in Collections:||College of Health Sciences|
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