ACCESS AND UTILIZATION OF MATERNAL CARE SERVICES AMONG RURAL WOMEN IN THE KUMBUNGU DISTRICT OF NORTHERN GHANA

Access and utilization of maternal health care services is still a challenge for some rural communities in Ghana. The study examined the quality of maternal health care services (MHCS) and the barriers that hindered access and utilization of MHCS in the Kumbungu district of northern Ghana. An exploratory sequential mixed method design was adopted and implemented in two phases. The phase I study (the quantitative component) involved the use of a questionnaire for a facility-based cross-sectional survey of 441 pregnant and postpartum women while the phase II study (the qualitative component) involved interviewing of 20 purposively sampled health service providers. An observational checklist was also used to assess the state of health facilities and to document the presence or absence of essential drugs and equipment. The study showed that 87.5% of participants attended ANC, 87.3% had skilled delivery and 84.8% had PNC visit within two days. Only 53.4% of participant women had up to four or more ANC visits. Second trimester registrants dominated (46.9%) in the study. Over half of study participants reported poverty, illiteracy, husbands’ restriction, distance of health facility from home and long queues in health facility as reasons for non-access and non-utilization of MHCS while over one-third of women blamed cultural practices in the community as the cause of delay in utilization of MHCS. The facility-based challenges that interfered with quality of care were inadequate midwives and absence of some equipment and essential drugs. To improve maternal health in the district, majority of study participants suggested that emphasis should be put on improving public education on maternal care, enforcing free MHCS and improving road network. Service providers recommended increasing the number of trained midwives and the provision of logistics such as ultrasound scan and delivery equipment for effective maternal care delivery. In addition to the above suggested interventions, both governmental and nongovernmental organizations should increase their investment on maternal health and also address the socioeconomic problems of women in the Kumbungu. district.