Why Muslim women in Northern Ghana do not use skilled maternal healthcare services at health facilities: a qualitative study.

John Kuumuori Ganle

doi:10.1186/s12914-015-0048-9

Abstract

BackgroundMuslim women are one sub-population in Ghana among whom the rate of skilled maternal health services accessibility and utilisation is very low. However, there are no studies in Ghana that explore the maternity needs and care experiences of Muslim women, and why they do not utilise maternal healthcare services at health facilities. The purpose of this paper is to explore the maternity healthcare needs and care experiences of Muslim women and the barriers to accessing and using maternal health services.MethodsQualitative research was conducted with 94 Muslim women in three communities in northern Ghana between November 2011 and May 2012. Data were analysed using the Attride-Stirling’s thematic network analysis framework.ResultsFindings suggest that although Muslim women do want to receive skilled care in a health facility, they often experience difficulties with accessing and using such services. These difficulties were often conditioned by a religious obligation to maintain bodily sanctity through modest dressing and the avoidance of unlawful bodily exposure or contact with certain people including male or alien caregivers. Other related access barriers include lack of privacy, healthcare providers’ insensitivity and lack of knowledge about Muslim women’s religious and cultural practices, and health information that lacked the cultural and religious specificity to meet Muslim women’s maternity care needs.ConclusionMaternal healthcare services designed to meet the needs of mainstream non-Muslim Ghanaian women might lack the flexibility and responsiveness to meet the unique maternity care needs of Muslim women. Recommendations for change include cultural competence training for healthcare providers and cultural/religious matching to meet Muslim women’s care needs and to enhance their care experience.

Highlights

Muslim women are one sub-population in Ghana among whom the rate of skilled maternal health services accessibility and utilisation is very low
The use of the appreciative inquiry approach in this study enabled exploration and description of both positive and negative elements within Islamic communities, and the identification of internal capacities, strengths, and activities Muslim women deemed effective for promoting access to and use of maternal health services in health facilities [17]
Childbirth and Muslim women’s maternity needs and care experiences Discussions and interviews with Muslim women showed that they valued safer childbirth for a number of reasons

Summary

Introduction

Muslim women are one sub-population in Ghana among whom the rate of skilled maternal health services accessibility and utilisation is very low. The survey suggests that more than 45% of births still occur at home and elsewhere without any form of skilled care (i.e. without the assistance of an accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal or uncomplicated pregnancies, childbirth, and the immediate postnatal period and in the identification, management, and referral of complications in women and newborns) This poor maternal health situation is compounded by widespread access inequalities between different socio-demographic groups across the country [2,10]

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