Assessment of reproductive health communication strategies in rural communities of Kassena-Nankana District, Ghana

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The purpose of the study was to generate relevant information that will inform decision-making in the design and implementation of reproductive health communication strategies in rural Kassena-Nankana district (KND) and other districts of similar socio-economic and cultural background. In this regard, qualitative and quantitative methods were used in rural KassenaNankana district to assess the reproductive health communication strategies in this part of the district. A total of 14 in-depth interviews and 12 focus group discussions involving health workers, Paramount chiefs, women’s groups (15 years and above) and elderly men were conducted. The quantitative study involved 239 respondents, randomly selected across the district. The study revealed the existence of various types of reproductive health services offered to people in rural Kassena-Nankana district. Survey respondents mentioned contraceptive services, STDs care and postnatal care as the most common reproductive health services in the community. Community members are also aware of the local reproductive health service places/persons in their communities where they can get reproductive health services and information. Fifty-two percent of the respondents indicated the clinics/hospitals while 37% mentioned the health workers as places/persons for reproductive health services and information. The reproductive health services that people use much in these communities are family planning services, antenatal counseling and care, postnatal counseling and care and STDs care. However respondents indicated that the family planning services are more patronized than the others. Both qualitative and quantitative surveys revealed various communication strategies used by health workers to communicate reproductive health services and information to rural people. Forty-six percent of survey respondents indicated that community durbars are the best communication strategy for advertising and promoting reproductive health services and information in rural communities. The health worker was identified as the most important source of reproductive health information in rural Kassena-Nankana district. Fifty-one percent of the respondents mention health worker. Seventy-three percent of respondents said they would prefer the health worker as their main source of reproductive health information. The study revealed that, payment of a bride wealth in the KND signifies a woman’s requirement to bare children and that the number of children that a woman brings forth depends on the will of God. There should therefore be no attempt to interfere with a woman’s childbirth artificially. More than half (55%) of the respondents in rural Kassena-Nankana district have never been to school and most (26%) of those who have been to school stopped at the basic level. What is worrisome is that less than 2% of rural populace in the Kassena-Nankana district had post secondary and higher education, 89% are farmers with less than 2 percent employed in the public/civil service. These have made the women especially vulnerable to poverty making it difficult for them to acquire the necessities for health, especially during the reproductive years when family needs are greatest. In the light of these findings in rural Kassena-Nankana district, there should be mass education and community sensitization on the benefits of reproductive health services offered to them. Given that most rural women are interested in the reproductive health services offered but do not have money to pay for them especially family planning services, it was recommended that income-generating activities (e.g. small irrigation schemes for dry season farming) be set up to enable women earn income to be able to use these services well. The District Health Administration needs to use more durbars and home visits as strategies for advertising and promoting reproductive health information among rural populace.
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfilment of the requirements for the award of Mph degree in Population and Reproductive Health, 2005