Abstract
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.
Highlights
1.1 Introduction to the ProblemThe reduction of maternal mortality and morbidity recently is viewed as top priority area in many developing countries (Bergstrom, 1994)
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana
All the examples on health-seeking behavior among the women happened after the introduction of the delivery exemption policy with major shifts in the financing of maternal health from local government to national insurance coverage
Summary
The reduction of maternal mortality and morbidity recently is viewed as top priority area in many developing countries (Bergstrom, 1994). It is expected that a 5.4% decline per annum is required to achieve the millennium development targets in the sub-Saharan African region (Wagstaff et al, 2004) This is obviously a tall mountain to climb for countries in this region. The decisions and choices of maternal services influenced by the organization and recent health financing reforms are the primary focus of this study. It is against this backdrop that the paper attempts to: 1. This paper presents outcomes on maternal health-seeking behavior after the country had introduced the delivery exemption policy alongside the organization of maternal health services.
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