The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61526

William K Bosu, Dr¹, Bertha Boakye-Agyeman¹, Lorinda Tetteh², Regina Langlah¹, Elias K Sory, Dr¹, and Kofi Awusabo-Asare, Prof³. (1) Regional Public Health Services, Ghana Health Service, PO Box 63, Cape Coast, Ghana, (2) District Health Directorate, PO Box 74, Elmina, Ghana, (3) Department of Geography, University of Cape Coast, University Post Office, Cape Coast, Ghana

While the national policy encourages providing maternal care within a sociocultural context, much effort to reduce Ghana’s maternal morbidity has focused on biomedical interventions. We interviewed 564 mothers in 15 communities who had a child aged <2 years about their beliefs and practices relating to maternal care and how these may impact safe motherhood programs. We interviewed community leaders and 29 traditional birth attendants (TBAs) from the same communities as well as 130 women at a prenatal clinic in one rural district.

We found that 84% of mothers used them during their last pregnancy and 73% during their current pregnancy. Various parts of plants were used but leaves were most common, often being administered by enema as a suspension. All study groups considered herbs important throughout pregnancy to improve maternal well-being, promote an uneventful pregnancy, prevent bleeding, facilitate labor and to ensure a healthy baby. They were considered safe and had been used for generations. Those harmful ones known to cause miscarriage or bleeding were known and avoided. Herbs were frequently used concurrently with western medicines but used exclusively for certain ailments. They were easily obtained from the residential premises at no cost. Relatives and less often TBAs influenced their initial use. Some TBAs, including trained ones used them in obstetric emergencies. In a logistic regression model, use of herbs was the strongest predictor of delivery outside of a health facility. Health workers’ dismissive attitudes towards herbal use should be reviewed in the light of the strong community incentives to use them. Further studies on the pharmacological properties of herbs are needed.

Learning Objectives:

• At the end of the presentation, participants will appreciate how sociocultural practices influence maternal health care behavior and outcomes.
• We argue that health programs that prescribe interventions without an understanding of the sociocultural basis for health behavior are unlikely to be successful.

Keywords: Access to Health Care, Maternal Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.