Obstetric Danger Signs and Factors Affecting Health Seeking Behaviour among the Kassena-Nankani of Northern Ghana: A Qualitative Study

Raymond A. Aborigo, Cheryl A. Moyer, Mira Gupta, Philip B. Adongo, John Williams, Abraham Hodgson, Pascale Allote, Cyril M. Engmann

Abstract

Improving community members’ knowledge of obstetric danger signs is one strategy for increasing the use of skilled care during pregnancy and the puerperium. This study explored knowledge of obstetric danger signs among a range of community members, examined the sources of their information, and the perceived factors that affect health seeking behaviour in rural northern Ghana. We conducted 72 in-depth interviews and 18 focus groups with community members. All interactions were audio taped, transcribed verbatim and analysed using NVivo 9.0. Community members demonstrated knowledge of a wide range of obstetric danger signs, including excessive bleeding, stomach aches, waist pains, vomiting and fever. Pregnant women learn about danger signs from a range of providers, and regular contact with formal providers typically coincided with increased knowledge of danger signs. Traditional remedies for problems in obstetrics are plentiful and cultural beliefs often restrict the use of allopathic medicine. Increasing knowledge of obstetric danger signs is necessary but not sufficient to overcome cultural preferences for traditional treatments for pregnancy danger signs. (Afr J Reprod Health 2014; 18[3]: 78-86)

 

Keywords: Obstetric danger signs, knowledge of danger signs, health seeking behaviour, antenatal care, maternal health, Ghana

 

Résumé 

Améliorer la connaissance des signes de danger obstétrical par les membres de la communauté est une stratégie visant à accroître l'utilisation des soins qualifiés pendant la grossesse et le post-partum. Cette étude a exploré la connaissance des signes de danger obstétrical parmi un éventail de membres de la communauté. Elle a étudié aussi les sources de leurs informations, et les facteurs perçus qui influent sur le comportement menant à la bonne santé dans les régions rurales du nord du Ghana. Nous avons effectué 72 entrevues en profondeur et de 18 groupes de discussion à cible auprès des membres de la communauté. Toutes les interactions ont été enregistrées sur bande audio, transcrites et analysées à l'aide de NVivo 9.0. Les membres de la communauté ont fait preuve d’une connaissance d'un large éventail de signes de danger obstétrical, y compris les saignements excessifs, des maux d'estomac, des douleurs à la taille, des vomissements et de la fièvre. Les femmes enceintes apprennent des signes de danger grâce à une gamme de fournisseurs et les contacts réguliers avec les fournisseurs officiels ont coïncidé en général  avec une meilleure connaissance des signes de danger. Les remèdes traditionnels  pour des problèmes pendant la grossesse sont abondants et les croyances  culturelles limitent souvent l'utilisation du  médicament allopathique. Améliorer la connaissance des signes de danger obstétrical est nécessaire mais pas suffisante pour surmonter les préférences culturelles pour les traitements traditionnels pour des signes de danger de la grossesse. (Afr J Reprod Health 2014; 18[3]: 78-86)

 

Mots-clés: signes de danger obstétrical,  connaissance des signes de danger,  comportement menant à la bonne santé,  soins prénatals,  santé maternelle, Ghana

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