Main Article Content

Abstract

This study investigates the factors influencing late initiation of antenatal care (ANC) among pregnant women in the Wa East District of Ghana, where maternal health outcomes remain a public health priority. Despite extensive evidence linking timely ANC to reduced maternal and neonatal mortality, late ANC attendance persists, especially in low-resource settings. Employing a facility-based cross-sectional study design, 405 pregnant women attending ANC were surveyed to identify socio-demographic, cultural, and healthcare service-related determinants of late ANC initiation. Findings reveal that older age, lower educational levels, farming occupations, and male-dominated decision-making significantly delay ANC attendance. Additionally, negative healthcare provider attitudes and geographical barriers further impede early ANC uptake. Regression analysis indicates that Muslim women and those with higher parity had markedly higher odds of late ANC initiation, while respectful healthcare provider attitudes and health education interventions reduced these odds. The study underscores the multifaceted barriers to timely ANC, emphasizing the need for culturally sensitive, community-based interventions involving male partners in maternal health education. Strategies to enhance respectful maternal care and improve healthcare access in remote settings are recommended as critical to fostering early ANC initiation. By addressing both socio-cultural and service-related barriers, this research contributes valuable insights for policy makers, healthcare providers, and community leaders aiming to improve maternal healthcare access and outcomes. Future research should explore the impact of male-inclusive health education and community health worker outreach on ANC attendance, fostering a robust understanding of effective maternal health interventions in rural Ghana and similar low-resource settings.

Keywords

Antenatal Care (ANC) Maternal Health Socio-cultural Barriers Health Service Accessibility Wa East District, Ghana

Article Details

How to Cite
Asomaning, E., & Beatrice Magbity HHCJ, R. S. J. . (2024). Socio-Cultural and Healthcare Barriers to Timely Antenatal Care Initiation Among Rural Ghanaian Women: A Case Study of Wa East District. Convergence Chronicles, 5(4), 16–28. https://doi.org/10.53075/Ijmsirq/65598238290

References

  1. Ghana Statistical Service [GSS]. (2013). 2010 Population and Housing Census: National Analytical Report. Accra: Ghana Statistical Service.
  2. Izacar, R., Adams, Y., & Kumaning, R. (2023). Barriers to antenatal care utilization in Ghana’s rural communities: A multi-level analysis. Maternal and Child Health Journal, 27(1), 45-56. https://doi.org/10.1007/s10995-023-03212-1
  3. Kaswa, R., Rupesinghe, G., & Longwe, D. (2018). Determinants of late antenatal care attendance among pregnant women in developing countries: A cross-sectional study. BMC Pregnancy and Childbirth, 18(1), 23-35. https://doi.org/10.1186/s12884-018-2035-8
  4. Sakeah, E., Okawa, S., Rexford, A., & Enuameh, Y. (2014). Socio-cultural factors influencing utilization of antenatal care services in Northern Ghana. Reproductive Health, 11(70), 70-78. https://doi.org/10.1186/1742-4755-11-70
  5. Tenaw, D., Getnet, A., & Sileshi, B. (2023). Exploring the role of spousal support in antenatal care utilization in rural Africa: Insights from Ghana. Journal of Public Health in Africa, 14(2), e202312. https://doi.org/10.4081/jphia.2023.e202312
  6. World Health Organization [WHO]. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization. https://doi.org/10.1093/heapro/daz036
  7. Ahmed, S., Creanga, A. A., Gillespie, D. G., & Tsui, A. O. (2019). Economic status, education, and empowerment: Implications for maternal health service utilization in developing countries. PLOS ONE, 14(3), e0214041. https://doi.org/10.1371/journal.pone.0214041
  8. Bohren, M. A., Hunter, E. C., Munthe-Kaas, H. M., Souza, J. P., Vogel, J. P., & Gülmezoglu, A. M. (2017). Facilitators and barriers to facility-based delivery in low- and middle-income countries: A qualitative evidence synthesis. Reproductive Health, 14(1), 56-66. https://doi.org/10.1186/s12978-017-0346-3
  9. Bohren, M. A., Tunçalp, Ӧ., Miller, S., & McCaw-Binns, A. (2019). Respectful maternity care in health facilities globally: A qualitative evidence synthesis. International Journal of Gynecology & Obstetrics, 147(1), 111-120. https://doi.org/10.1002/ijgo.12848
  10. Fekadu, G. A., & Regassa, N. (2014). Skilled delivery care service utilization in Ethiopia: Analysis of rural-urban differentials based on national demographic and health survey. BMC Public Health, 14, 423. https://doi.org/10.1186/1471-2458-14-423
  11. Ganle, J. K., Parker, M., Fitzpatrick, R., & Otupiri, E. (2015). Socio-cultural barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition. International Journal for Equity in Health, 14, 123. https://doi.org/10.1186/s12939-015-0241-0
  12. Kabakyenga, J. K., Östergren, P.-O., Turyakira, E., & Pettersson, K. O. (2016). Influence of birth preparedness, decision-making on location of birth and assistance by skilled birth attendants among women in southwestern Uganda. PLOS ONE, 11(10), e0163413. https://doi.org/10.1371/journal.pone.0163413
  13. Mutua, M. K., Kimani-Murage, E., & Ettarh, R. (2018). Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated? BMC Public Health, 18, 262. https://doi.org/10.1186/s12889-018-5127-4
  14. Pell, C., Meñaca, A., Were, F., Afrah, N. A., Chatio, S., Manda-Taylor, L., ... & Pool, R. (2013). Factors affecting antenatal care attendance: Results from qualitative studies in Ghana, Kenya, and Malawi. PLOS ONE, 8(1), e53747. https://doi.org/10.1371/journal.pone.0053747
  15. Sialubanje, C., Massar, K., Hamer, D. H., & Ruiter, R. A. (2015). Understanding the role of community health workers in improving maternal health care in rural settings: Insights from Zambia. BMC Pregnancy and Childbirth, 15, 212. https://doi.org/10.1186/s12884-015-0654-7
  16. Yaya, S., Bishwajit, G., Uthman, O. A., Amouzou, A., & Bishwajit, S. (2020). Why women who intend to deliver in health facilities fail to do so: A cross-sectional study in Bangladesh. BMC Pregnancy and Childbirth, 20, 679. https://doi.org/10.1186/s12884-020-03387-8