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Cited by 58Global Maternal and Child HealthGlobal Health Workforce IssuesMaternal and Perinatal Health Interventions

Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana?

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Sakeah, Evelyn, McCloskey, Lois, Bernstein, Judith, Yeboah-Antwi, Kojo, Mills, Samuel, Doctor, Henry V·2014·BMC Health Services Research
DOI 10.1186/1472-6963-14-340PMC PMC4251607
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Abstract

BACKGROUND: In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. METHODS: We employed an intrinsic case study design with a qualitative methodology. We conducted 29 in-depth interviews with health professionals and community stakeholders. We used a random sampling technique to select the CHO-midwives in three Community-based Health Planning and Services (CHPS) zones for the interviews and a purposive sampling technique to identify and interview District Directors of Health Services from the three districts, the Regional Coordinator of the CHPS program and community stakeholders. RESULTS: Community members play a significant role in promoting skilled delivery care in CHPS zones in Ghana. We found that community health volunteers and traditional birth attendants (TBAs) helped to provide health education on skilled delivery care, and they also referred or accompanied their clients for skilled attendants at birth. The political authorities, traditional leaders, and community members provide resources to promote the skilled delivery program. Both volunteers and TBAs are given financial and non-financial incentives for referring their clients for skilled delivery. However, inadequate transportation, infrequent supply of drugs, attitude of nurses remains as challenges, hindering women accessing maternity services in rural areas. CONCLUSIONS: Mutual collaboration and engagement is possible between health professionals and community members for the skilled delivery program. Community leaders, traditional and political leaders, volunteers, and TBAs have all been instrumental to the success of the CHPS program in the UER, each in their unique way. However, there are problems confronting the program and we have provided recommendations to address these challenges.

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  • Most Yoruba women are socialised into feeling embarrassed by the idea of undergoing a vaginal examination by a medical practitioner.

    “Most Yoruba women are thus socialised into feeling embarrassed by the idea of undergoing a vaginal examination by a medical practitioner.8,13”

    From Towards the development of a community-based model for promoting cervical cancer prevention among Yoruba women in Ibadan Nigeria: application of PEN-3 model (2019) · cites this paper as [13]

    The Results section discusses customs that prevent some women in rural Ghana from visiting health facilities, and the Discussion section addresses barriers to skilled birth attendance. Neither addresses Yoruba women, embarrassment about vaginal examinations, or whether most women are socialised to feel that way. Searches for Yoruba women and for examination-related embarrassment found no matching passage in our copy. (LLM, conf=0.76)

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Research works printed but not linked: 24

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  24. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1472-6963/14/340/prepub

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Authors
Sakeah, E., McCloskey, L., Bernstein, J., Yeboah-Antwi, K., Mills, S., & Doctor, H. V.
Affiliations
  • Navrongo Health Research Centre (GH)
  • Boston University (US)
  • World Bank (US)
  • United Nations Office on Drugs and Crime (AT)
Corresponding author
Sakeah, Evelyn
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2014-08-11
Volume
14
Issue
1
Pages
340-340
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/1472-6963-14-340
PMC
PMC4251607
OpenAlex
W2017686344
Cited by
58
References
2
Citations by year
2026: 4 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 2 · 2019: 8 · 2018: 2 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 1
FWCI
5.33
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
community participation, skilled delivery, Community-based Health Planning and Services, community health officers, midwifery education, maternal mortality, rural health care, traditional birth attendants, community health volunteers, referral rewards, access to maternal health services, health education, Upper East Region, Ghana
MeSH terms
Adult, Data Collection, Female, Ghana, Humans, Maternal Health Services, Midwifery, Population Surveillance, Pregnancy, Rural Population, Community Health Planning, Rural Health Services, Qualitative Research

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