Increasing the use of professional midwifery care during childbirth in low income urban areas in Ghana

This study focused on identifying strategies to increase the use of professional care during childbirth in low income urban areas in Ghana. The aimed was to examine the factors that influence the use of midwifery care for maternal and neonatal health policy and program interventions. The study used interviews, focus group discussions and a questionnaire survey to gather data on the nature of delivery care options available to women and factors that influence use of each care. The sample population comprised 394 participants: 300 women survey participants, 12 interview participants consisting of 2 public sector midwives, 2 social workers, 8 women, and 82 women focus group discussion participants. Results indicated that 3 options of care exist for women during childbirth: professional midwifery care, traditional birth attendant care and spiritual care. Women mainly used midwifery care because of its quality and safety. However, negative attitudes of public sector midwives towards clients, indirect cost of seeking midwifery care and affectionate care provided by traditional birth attendants were significant barriers to seeking midwifery care in public health facilities. Women used spiritual care because they believe it could offer spiritual protection against death and any possible complications during childbirth. To considerably increase the use of midwifery care among women in low income urban areas in Ghana, stringent interventions have to be in place in public health facilities to reduce indirect cost associated with seeking delivery care there, improve public sector midwife-client interaction and strengthen community education on the benefits of midwifery care during childbirth.