The role of rural transport in achieving reduction in maternal and child mortality in the Gushegu District of Ghana

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The role of rural transport in ensuring rural development cannot be overemphasized. Improved access to transport services, thereby increasing mobility can clearly help in reducing all aspects of poverty. Improved Rural transport therefore can be regarded as the panacea to development. Governments all over the world in their quest to reducing poverty have adopted the Millennium Development Goals which are concrete measures for judging performance through a set of inter-related commitments, goals and targets on development, governance, peace, security and human rights. These Goals set the framework towards poverty reduction, and reflect the national development strategies of these countries. With the inclusion of both maternal and child mortality reduction as the Fourth and Fifth Millennium Development Goals (MDGs) has stirred increased attention to the multi- sectoral nature of these challenges. The transport sector has a critical role to play in achieving these Millennium Development Goals. According to ISSER (2007), the world is on track to halve extreme poverty by 2015; however, prospects are more uncertain for the goals of reducing child and maternal mortality. In Ghana, there is evidence that the gains made in the late 1990s and early 2000s have rapidly been eroded, with infant deaths in the first month accounting for most of this decline. Neonatal mortality rates increased from 30 per 1000 live births in 1998 to 43 per 1000 lives births in 2003, Gaps in antenatal care, unsupervised deliveries and inadequate postnatal care account for the high levels of maternal deaths. The current estimate of maternal mortality ratio in Ghana is about 503 deaths per100,000 live births and it is quite likely that the MDG of achieving about 250 deaths per 100,000 lives may not be realized by 2015. The transport sector has the potential to improving access to health care, thereby increasing access to antenatal care, supervised deliveries and postnatal care. It is in the light of the above that, this study sought to establish the relationship between rural transport and achieving a reduction in both child and maternal mortality. The cross sectional design was adapted for the study. Relevant secondary data (literature) was reviewed and primary data was gathered by the use of questionnaire. A total of 160 household questionnaire targeted at mothers were administered. Additionally, questionnaire for the institutions like the District Health Directorate, District Assembly, and seven Health facilities. Further more Questionnaire targeted at Traditional Birth Attendants and Transport Operators were also administered. The findings of the survey indicated that, transport infrastructure, with regards to roads in the District are generally poor; the surfaces of these roads are bad to the extent that, some of them become immotorable in the rainy season. This situation resulted in the low volume of vehicles that plied the roads in the rural areas of the district. It was further discovered that, riding bicycle and walking were the most dominant modes of transport. Motorized transport that is readily available is the motor bike of which few elites of the society own. Additionally, it was revealed that, access to health facilities was a problem; this is resulting from the fact that, transport infrastructure and services provided in the District are inadequate and in a poor state. Access to health facility is also compromised by the distance to these health facilities as shown by the accessibility map. Pregnant women and lactating mothers therefore find it difficult to move from their homes to the health facilities. Also, outreach services by health personnel are hampered by the deplorable situation of rural transport in the District. This situation does not arguer well for improvement in maternal and child mortality. An improvement in the provision of rural transport will contribute to improving accessibility to health facilities by pregnant women and lactating mothers. This therefore will serve as an impetus to achieving a reduction in maternal and child mortality in the Gushegu District. iv  
A Thesis Submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, In partial Fulfillment of the Requirement for the Degree of Master of Science (Development Planning and Management) Faculty.