Late arrival of women with pregnancy related complications to Mampong District Hospital-Ghana the underlying factors

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Maternal mortality is the result of complex interaction between biological and socioeconomic factors, which should be organized in a meaningful way. An estimated 75% of maternal death result from direct causes such as haemorrhage, infection/sepsis toxemia and unsafe abortion.(WHO, 1995) Most of these deaths could have been prevented with timely medical intervention. Delay in reporting PRC emerge as the pertinent factor contributing to maternal death. This study was conducted in Sekyere West District in Ashanti region to ascertain what factors are contributing to the late reporting to the District Hospital by pregnant women with complications. In all, 150 women who have had pregnancy related complications within the last five (5) years (1999-2004) and six health personnel were interviewed. The multistage sampling approach was used in the selection of respondents. The sample methods used were convenient and simple random sampling in the communities and purposive sampling for the health professionals. Questionnaire and interviews were the main methods for data collection. Epi info was used to analyze the results. The study identified lack of knowledge on what constitute pregnancy complication as one of the causes of delayed reporting to the hospital. Most respondent (50.0%) did not know what is termed as the danger signs of pregnancy, thereby making it difficult for them to report early to the hospital. The study revealed that the mean distance from the health facility and place of residence was S.2lcm.Ancj most of the respondents used public transport as a means of transport to the hospital which delays their arrival to the hospital. They spent an average of 16.14 minutes in traveling to the hospital. The cost (70,000-150,000) of receiving treatment during pregnancy was high compared with the monthly income of the respondents. The study showed that the respondents were very much satisfied with the conduct of the staff in the hospital. From the findings of this study it was concluded that certain factors such as high illiteracy rate among pregnant women, high parity, delayed referral from peripheral clinics, unsafe abortion, poverty, gender discrimination and high cost of seeking health care were some of the reasons why most pregnant women reported late to the hospital. Recommendation was therefore made to the effect that health education given to pregnant women at ANC should be intensified.
A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of in Health Services Planning and Management, 2004