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APHA Scientific Session and Event Listing

Recorded presentation

Elaine Menotti, MPH¹, Margaret Hamilton², Michelle Prosser², Emily Sonneveldt², and Penney Davis². (1) University of Michigan Population Fellow, Futures Group/POLICY Project, One Thomas Circle, Suite 200, Washington, DC 20005, (2) The Futures Group, One Thomas Circle NW, Suite 200, Washington, DC 20005, 202-775-9680, esonneveldt@futuresgroup.com

While Ghana's maternal mortality and fertility rates have declined since the 1990s, in 2000 the maternal mortality rate measured 540 deaths per 100,000 live births. Midwives are the main source of antenatal, delivery and postpartum care, including Emergency Obstetric Care (EOC), for Ghanaian women. The top five causes of maternal mortality and morbidity (hemorrhage, sepsis, unsafe abortion, eclampsia, and obstructed labor) can be effectively addressed by midwives and ensuring access to appropriate and affordable midwifery care has the potential to save millions of women's and newborn's lives.

A pilot study was conducted in six districts in Ghana to assess women's ability to access comprehensive reproductive health care, including EOC. The project identified the geographic the location of midwives through GIS mapping, compiled information on their education and professional preparation, age, and the range of services they provide via an administered survey; and conducted focus group discussions to understand, from the perspective of midwives, the barriers they encounter in providing comprehensive reproductive health care. The pilot study results show that policies and guidelines regarding training and continuing education, prohibited procedures, recruitment and retention and government reimbursement limit their ability to provide comprehensive services. While most basic services are available in each district, limited numbers of midwives and distances to services may act as barriers to care and in some districts specialized care may not be available at all. The paper includes policy recommendations to address identified barriers and suggestions for future midwife mapping activities and research.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Articulate the methodology used in the presented pilot study, including the use of Geographic Information Systems to assess geographic availability of services provided by midwives.
• Discuss barriers to providing comprehensive reproductive health care services as described by midwives.
• Articulate findings of pilot study regarding women’s ability to access comprehensive reproductive health care, including emergency obstetric care, in Ghana.
• List policy recommendations suggested to increase women’s access to comprehensive reproductive health care in Ghana.

Keywords: Access and Services, International Reproductive Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation