International Journal of Health Sciences March 2016, Vol. 4, No. 1, pp. 1-10 ISSN: 2372-5060 (Print), 2372-5079 (Online) Copyright © The Author(s). All Rights Reserved. Published by American Research Institute for Policy Development DOI: 10.15640/ijhs.v4n1a1 URL: http://dx.doi.org/10.15640/ijhs.v4n1a1 Motivations for Non-Formal Maternal Health Care in Low-Income Communities in Urban Ghana Patricia Anafi 1 , Wisdom K. Mprah 2 , David R. Buchanan 3 , Aline C. Gubrium 4 , Ralph Faulkingham 5 & Margaret Barton-Burke 6 Abstract Considerable efforts are being made to improve access to maternal health care in order to reduce maternal mortality rate in Ghana. However, the use of non-formal care during pregnancy and childbirth among women still remain high in some communities. In this study, we investigated factors influencing the use of non- formal health care by women during pregnancy and childbirth, when formal health care services are readily available, in a centrally-located low-income neighborhood in Accra, the capital city of Ghana. Twelve (12) focus group discussions and six (6) individual interviews were conducted with ninety (90) women who had at least one child, to examine factors determining the use of non-formal health care during pregnancy and child birthing. Traditional birth attendant and spiritual care were identified as forms of non-formal maternal health care utilized by pregnant women. Cost of seeking formal health care, the belief that traditional birth attendants and spiritual churches could offer spiritual protection during childbirth, fear of cesarean delivery, the belief in the potency of herbal medicine in sustaining pregnancy, lack of antenatal clinic attendance, and influence of parents on site of delivery were reasons for preference for non-formal health care by pregnant women. The findings point to the need to look beyond formal physical access, the need for government absorbing full cost of maternal care for women who cannot pay, to accommodating women’s religious beliefs and integrate non-formal health care providers into the formal health care system in low income urban communities in Ghana. Keywords: Non-formal health care, maternal health, care seeking behavior, low income communities, urban Ghana 1.0 Introduction High maternal mortality rates continue to be a major public health concern globally. The World Health Organization (WHO) estimates that about 800 women die from pregnancy-related complications each day, and over a quarter a million maternal deaths still occur worldwide, despite the sustained efforts by governments and non- governmental organizations around the world to reduce maternal death (WHO, 2014). 1 PhD, MPhil, Department of Community Health, State University of New York at Potsdam, Potsdam, NY, USA. 2 PhD, MPhil, Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana. 3 Dr.PH, MPH, Department of Health Promotion & Policy, School of Public Health & Health Sciences, University of Massachusetts-Amherst, MA, USA. 4 PhD, M A, Department of Health Promotion & Policy, School of Public Health & Health Sciences, University of Massachusetts-Amherst, MA, U.SA 5 PhD, M A, Department of Anthropology, University of M assachusetts-Amherst, M A, U.S.A. 6 PhD, M S, RN, M emorial Sloan-Kettering Cancer Center, New York, New York, USA.