Barriers to accessing maternity care among expectant mothers at Tamale teaching Hospital

Abstract

Maternal mortality remains a major challenge to developing countries. Access to maternal health services is crucial to ensuring safe motherhood care before, during and after delivery. This study sought to explore barriers to accessing maternity care among expectant mothers at a Teaching Hospital. A facility-based cross-sectional study was conducted. The systematic random sampling technique was used to sample 345 pregnant women for the study. Structured questionnaires were used to collect data from women regarding barriers to accessing maternity care. Data were analyzed using Statistical Package for Social Sciences (SPSS). Demographics (age, ethnicity, education, marital status, occupation) were summarized using frequency tables while the χ2 test used to determine associations between respective variables. Variables that displayed significant associations were entered into a multiple logistic regression model to ascertain the strength of association (Odds Ratios) between respective variables. At the 95% confidence interval, a p-value less than 0.05 was deemed statistically significant. The results showed that 89.6% agreed maternal health services were available at the Tamale Teaching Hospital but, over 66.4% could not access these services due to the judgmental attitude of health staff at the facility. About 72.1% could not access lifesaving care due to lack of means of transport especially ambulance service. Another barrier mentioned in this study was the deplorable road network which hindered 68.7% of participants from accessing maternal health care. The χ2 analysis revealed that age (p<0.05), religion (p<0.05), educational status (p<0.01), level of knowledge on obstetric risks (p<0.01), number of ANC visits (p<0.01), marital status (p<0.05), income level of participants (p<0.01) and cost of services (p<0.01) determined access to healthcare services and the choice of facility delivery among the study women. Generally, logistics, and refurbishment, building of more hospital at least two in each district and the training of more health workers with positive attitude toward clients are necessities in order to adequately address access barriers. Until road networks in the country are properly constructed and accessible to all parts of Ghana, the effort to reduce maternal mortality will be unattainable