Factors influencing supervised delivery in Shama Ahanta East Metropolitan area (S.A.E.M.A)

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Maternal mortality is a global concern. The high maternal mortality of 204 per 100,000 live births in Ghana leaves much to be desired. Most maternal deaths are caused by five obstetric complications, namely, haemorrhage, sepsis, unsafe induced abortion, hypertensive disorders of pregnancy and obstructed labour. One way of reducing this predicament is to ensure all pregnant women have access to skilled care during labour and delivery. A study was undertaken between August and October 2003 to assess the factors influencing supervised deliveries in Shama Ahanta East Metropolitan Area. Two (2) sub-metros (Kwesimintsim and Essikado) were selected out of the 5 sub-metros in the metropolis. This was done by simple random sampling. The survey was a descriptive cross-sectional study with a sample size of 169. The sample size was determined by using Epi-Info Stalcac 2000. This comprised 150 clients, 14 health workers from the maternity units as well as 5 TBAs. The sampling techniques used were purposive, simple random and systematic sampling methods. Primary data were collected using questionnaires for clients and interview schedule for nurse midwives as well as TBAS. Secondary data were also collected from health care facilities. The data was coded and analyzed using Epi-Info statistical package. The study results revealed that socio-demographic as well as geographical factors, like distance and means of transport to health care facilities had no negative impact on supervised delivery. However, high delivery charges (57.1%) at health care facilities, clients’ inability to fully appreciate the benefits of supervised delivery (72.0%) and the poor attitudes of some health workers towards clients influenced low supervised delivery in SAEMA. It is recommended that the Government of Ghana provide funds to MOH/GHS to make supervised delivery at health care facility virtually free for all pregnant women in the metropolis. Additionally, programmes to intensify the awareness of the benefits of supervised delivery in the metropolis must be mounted by the MHMT in order to address the partial appreciation by clients on the benefits of supervised delivery. Lastly, an award scheme must be meted out to health workers by the MHMT based on their attitude towards clients.
A dissertation presented 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 MSc.degree in Health Services Planning and Management, 2004