Public Health Research 2014, 4(3): 92-97
DOI: 10.5923/j.phr.20140403.03
Contextualising Women Decision Making during Delivery:
Socio-Cultural Determinant of Choice of Delivery Sites in
Ghana
Adadow Yidana
*
, Mustapha Issahaku
Department of Community Health and Family Medicine, School of Medicine and Health Sciences, University for Development Studies,
Tamale, Ghana
Abstract The welfare of women and children continue to be at the forefront of national and global millennium health
policies. Though these programs and initiatives have been put into place, maternal mortality is still a challenge in many
developing countries including Ghana. In many rural communities across the country, quite a number of deliveries still take
place at home without skilled supervision. This paper sought to establish sociocultural impediments to the use of health
facility as the most ideal place of delivery among a cross section of women in the northern part of Ghana. Using a purposive
sampling method, a total of 120 nursing mothers were interviewed. The results suggest a positive relationship between
increasing maternal formal education, household income and possibility of delivering at a health facility. However, social and
cultural factors have been noted to exert a greater impact on the choice of delivery sites. In view of this, the paper suggests a
modification of traditional practices to suite current happening. In addition to the above, there is also the need for deployment
of resources needed to combat home delivery, or even if at, make it safer.
Keywords Delivery, Health facility, Tradition, Women, Midwives
1. Introduction
The health and general wellbeing of women during
childbirth plays a critical role in the improvement of
reproductive health. The desire to improve reproductive
health globally has generated an ongoing debate in parts of
the developed world, especially with regard to the right of
women to decide whether to deliver at a health facility or at
home [15]. Studies on maternal and child health have
generated quite a number of useful data in developing
countries, majority of which are related to undesirable
outcome of home delivery amongst women [22]. The rate at
which women receive antenatal care and its quality is very
important in predicting the outcome of choice of delivery
sites in many developing countries [1]. Thus, policy makers
have instituted timely and supervised skilled delivery as a
right of every woman, putting the welfare of women at the
forefront of national and global health policies [17]. It has
often been argued that many of the deliveries still take place
at home instead of health care facilities. This situation, it is
argued, could lead to loss of lives during delivery, resulting
from hitherto preventable causes if not managed well. It is
* Corresponding author:
adadowy@yahoo.com (Adadow Yidana)
Published online at http://journal.sapub.org/phr
Copyright © 2014 Scientific & Academic Publishing. All Rights Reserved
on the bases of this that [11] have indicated many maternal
deaths could be prevented if all deliveries are managed by
skilled personnel.
In situations where deliveries take place outside health
care facilities, tracking and correcting complications
becomes a daunting task. It is here that [5] are right in their
observation that pregnancy related complications cannot be
reliably predicted. It is against this challenge that, attempts to
address women’s needs and health problems have become a
major focus globally [17]. Available statistics at the global
stage suggest that more than 60 million women deliver at
home without skilled care, and about 530 000 die from
pregnancy related complication, with 3 million babies
coming out as stillbirth [18].
Individual choice for location of childbirth is embedded in
society’s conceptualisation of the situation, often seen as a
social process. Cultural diversity often leads to differences in
the conceptualisation of childbirth in parts of the developing
countries, creating a platform where expectant mothers feel
reluctant to use health care facilities in times of pregnancy
related complications. Consequently, some expectant
mothers have developed the penchant of observing normal
home births, often surrounded by their families as a
normative activity [6]. In a traditionally oriented society,
most newborns are delivered at home with the assistance of
traditional birth attendants [10], majority of who are not
trained. To encourage deliveries at health care settings, and