Factors Contributing to Maternal Mortality: The Case of Bawku West District in the Upper East Region Ghana

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This is a cross-sectional study of 341 household on factors that accounts for high maternal mortality in Bawku East district, in Upper East region of Ghana. The objectives of the study were to: ascertain the incidence of non-institutional maternal deaths in the district; determine the differences in backgrounds of maternal deaths and non-maternal death; assess the health seeking behaviour of cases of maternal deaths; and identify and describe the socio-cultural influences that accounted for maternal deaths in the district. The methodology used was a multistage sampling for the administration of interview guide in Tilli /Widnaba, Zebilla and Zongoire sub-districts. In addition, the purposive sampling technique was used to conduct a focus group discussion with men, women and compound heads in the selected communities. The results showed that, a maternal death per household was 158 per 1000 households which occur mainly at home (58%). The trend of maternal death in the communities is increasing, recording seven in 2004 and 37 in 2007. Most (54.8%) of the maternal deaths occurred after the women had delivered. When characteristics of maternal death cases and non-maternal death cases were compared, it was evident that: maternal death cases were significantly occurring among the younger age mothers with (chi square = 21.6, p=0.00); being married reduced the risk of maternal death significantly (chi = 5.34, p = 0.02; OR = 0.35); It was also evident that the risk of maternal death among women with no formal education was 3.27, 2.29 and 8.02 folds compared with the event in mothers who had 1st cycle, 2nd cycle and tertiary educated women respectively. On health seeking behaviour it is demonstrated that maternal death cases (47.2%) did not use ANC services because they were prevented by their compound heads. There are embedded cultural and traditional barriers to accessing maternity services. They are the use of soothsaying, libation, consultation with ancestors and use of herbs for pregnant women before orthodox services is contacted. It is recommended that women and women groups should advocate through the chiefs, opinion leaders, compound heads, and by the facilitative efforts of the district assembly, the district health directorate and Mr. Abotzabire Azambarima William (Author of this document),to help enact by-laws and ensure its’ implementation in curtailing the cultural practices that prevents women for seeking prompt maternity care.
A dissertation submitted to the school of graduate studies, Kwame Nkrumah University of science and technology, Kumasi in partial fulfillment of the requirement for the award of MPH degree in Health Education and Promotion,