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Does knowledge on socio-cultural factors associated with maternal mortality affect maternal health decisions? A cross-sectional study of the Greater Accra region of Ghana.

ABSTRACT: BACKGROUND:The concern of all maternal health stakeholders is to improve maternal health and reduce maternal deaths to the barest minimum. This remains elusive in low and middle-income countries as the majority of factors that drive maternal deaths stem from the socio-cultural environment especially in rural settings. This study was aimed at finding out if knowledge on socio-cultural factors related to maternal mortality affects maternal health decisions in rural Ghana. METHODS:Community-based cross-sectional in design, the study involved 233 participants from 3 rural districts in the Greater Accra Region. Mixed-method of data collection was employed after informed consent. Quantitative data were analyzed using simple statistics, Fisher's Exact Test of independence and crude odds ratio were used to interpret the results, whilst the FGDs were recorded, transcribed and analyzed based on themes. RESULTS:Statistically, significant relationship exists between all the socio-cultural factors studied (Traditional Birth Attendants (TBAs), religious beliefs and practices, herbal concoctions, and pregnancy and childbirth-related taboos) and maternal health decisions (p?=?0.001 for all the variables) with very strong associations between maternal health decisions and knowledge on pregnancy and childbirth related taboos, TBA patronage, and religious beliefs and practices (OR?=?21.06; 13; 7.28 respectively). However, misconceptions on factors associated with maternal mortality deeply rooted in rural communities partly explain why maternal morbidity and mortality are persistent in Ghana. CONCLUSION:Meaningful and successful interventions on maternal mortality can only be achieved if misconceptions on causes of maternal mortality especially in rural areas of the country are tackled through mass education of communities. This should be done consistently over a long period of time for sustained behavioral change.

SUBMITTER: Yarney L

PROVIDER: S-EPMC6350397 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Does knowledge on socio-cultural factors associated with maternal mortality affect maternal health decisions? A cross-sectional study of the Greater Accra region of Ghana.

Yarney Lily L

BMC pregnancy and childbirth 20190128 1

<h4>Background</h4>The concern of all maternal health stakeholders is to improve maternal health and reduce maternal deaths to the barest minimum. This remains elusive in low and middle-income countries as the majority of factors that drive maternal deaths stem from the socio-cultural environment especially in rural settings. This study was aimed at finding out if knowledge on socio-cultural factors related to maternal mortality affects maternal health decisions in rural Ghana.<h4>Methods</h4>Co ...[more]

PMID: 30691397

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Project description:ObjectivesTo explore the "how" and "why" of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes.MethodsA cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnaire and observational checklist to frontline providers of maternal and newborn care.ResultsTacit knowledge or 'mind lines' was an important primary approach to care decision making. When available, protocols and guidelines were used as decision making aids, especially when they were simple handy tools and in situations where providers were not sure what their next step in management had to be. Expert opinion and peer consultation were also used through face to face discussions, phone calls, text messages, and occasional emails depending on the urgency and communication medium access. Health system constraints such as availability of staff, essential medicines, supplies and equipment; management issues (including leadership and interpersonal relations among staff), and barriers to referral were important influences in decision making. Frontline health providers welcomed the idea of interventions to support clinical decision making and made several proposals towards the development of such an intervention. They felt such an intervention ought to be multi-faceted to impact the multiple influences simultaneously. Effective interventions would also need to address immediate challenges as well as more long-term challenges influencing decision-making.ConclusionSupporting frontline worker clinical decision making for maternal and newborn services is an important but neglected aspect of improved quality of care towards attainment of MDG 4 & 5. A multi-faceted intervention is probably the best way to make a difference given the multiple inter-related issues.

Project description:Globally, little evidence exists on transmission patterns of COVID-19. Recommendations to prevent infection include appropriate and frequent handwashing plus physical and social distancing. We conducted an exploratory observational study to assess compliance with these recommendations in selected transportation stations in Ghana. A one-hour audit of 45 public transport stations in the Greater Accra region was carried out between 27th and 29th March 2020. Using an adapted World Health Organization (WHO) hand hygiene assessment scale, the availability and use of handwashing facilities, social distancing, and ongoing public education on COVID-19 prevention measures were assessed, weighted and scored to determine the level of compliance of stations. Compliance with recommendations was categorized as "inadequate" "basic", "intermediate" and "advanced", based on the overall score. Majority (80%) of stations in Accra have at least one Veronica Bucket with flowing water and soap, but the number of washing places at each station is not adequate. Only a small minority (18%) of stations were communicating the need to wash hands frequently and appropriately, and to practice social/physical distancing while at the station. In most stations (95%), hand washing practice was either not observed, or only infrequently. Almost all stations (93%) did not have alcohol-based hand sanitizers available for public use, while social distancing was rarely practiced (only 2%). In over 90% of the stations, face masks were either not worn or only worn by a few passengers. Compliance with COVID-19 prevention measures was inadequate in 13 stations, basic in 16 stations, intermediate in 7 stations, and advanced in 9 stations. Compliance with COVID-19 prevention measures in public transportation stations in the Greater Accra region remains a challenge. Awareness creation should aim to elevate COVID-19 risk perception of transportation operators and clients. Transport operators and stations need support and guidance to enforce hand washing and social distancing.

Project description:BackgroundInfluenza-like Illness (ILI) is a medical diagnosis of possible influenza or another respiratory illness with a common set of symptoms. The deaths of four schoolchildren, during a pandemic influenza outbreak in December 2017 in Ghana, raised doubts about the ILI surveillance system's performance. We evaluated the ILI surveillance system in the Greater Accra region, Ghana, to assess the system's attributes and its performance on set objectives.MethodsCDC guidelines were used to evaluate the data of the ILI surveillance system between 2013 and 2017. We interviewed the surveillance personnel on the system's description and operation. Additionally, routinely entered ILI data from the National Influenza Center provided by the six sentinel sites in Accra was extracted. We sampled and reviewed 120 ILI case-investigation forms from these sites. Surveillance activities were examined on system's performance indicators, each being scored on a scale of 1 to 3 (poorest to best performance).ResultsAll population and age groups were under ILI surveillance over the period evaluated. Overall, 2948 suspected case-patients, including 392 (13.3%) children under-five were reported, with 219 being positive for influenza virus (Predictive value positive = 7.4%). The predominant influenza subtype was H3N2, recorded in 90 (41.1%) of positive case-patients. The system only met two out of its four objectives. None of the six sentinel sites consistently met their annual 260 suspected case-detection quota. Samples reached the laboratory on average 48 hours after collection and results were disseminated within 7 days. Of 120 case-investigation forms sampled, 91 (76.3%) were completely filled in.ConclusionsThe ILI surveillance system in the Greater Accra region is only partially meeting its objectives. While it is found to be sensitive, representative and timely, the data quality was sub-optimal. We recommend the determination of thresholds for alert and outbreak detection and ensuring that sentinel sites meet their weekly case-detection targets.

Dataset Information

Does knowledge on socio-cultural factors associated with maternal mortality affect maternal health decisions? A cross-sectional study of the Greater Accra region of Ghana.

Publications

Does knowledge on socio-cultural factors associated with maternal mortality affect maternal health decisions? A cross-sectional study of the Greater Accra region of Ghana.

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