Addressing the continuum of maternal and newborn care in Ghana

Implications for policy and practice

Bibliographic Data

ID11492375
AuthorsCyril M Engmann, Cyril Engmann (Program for Appropriate Technology in Health, corresponding author), Abraham Hodgson (0009-0003-0700-1364, Ghana Health Service), Raymond A Aborigo (0000-0003-0642-9265, Navrongo Health Research Centre), Raymond Aborigo, Philip Baba Adongo (0000-0002-0614-4756, University of Ghana), Philip L Adongo, Cheryl A Moyer (0000-0002-5796-157X, University of Michigan)
Year2016
Volume31
Issue10
Pages1355-1363
Publication date2016-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czw072
PMID27354099
OpenAlexW2474953516
LanguageEN
Citations received6
References cited29

Although the past decade has brought global reductions in maternal, infant and child mortality, many low-resource settings have failed to make significant gains relative to their high-income counterparts. In Ghana, nearly 50% of under-five mortality in 2014 could be attributed to deaths during the first 28 days after birth. This article analyses the data across a mixed-methods study of the factors impacting maternal and neonatal care in northern Ghana. The stillbirth and neonatal death study (SANDS) was conducted in 2010 and included both quantitative (N = 20 497) and qualitative data collection (N = 253) to explore the issues associated with the continuum of reproductive health care. Findings were compared against an adaptation of the WHO/UNICEF framework for integrated maternal and newborn care and used to generate concrete recommendations for clinicians, policymakers and programmers across the continuum of care, from pregnancy through delivery and postnatal care. SANDS elucidated epidemiological trends: 40% of neonatal deaths occurred on the first day after birth, and the leading causes of early neonatal mortality were birth asphyxia/injury, infection and complications of prematurity. Qualitative data reflect findings along two axes-community to facility-based care, and pre-pregnancy through the postnatal period. Resulting recommendations include the need to improving clinicians' understanding of and sensitization to local traditional practices, the need for policies to better address quality of care and coordination of training efforts, and the need for comprehensive, integrated programmes that ensure continuity of care from pre-pregnancy through the post-partum period. SANDS illustrates complex medical-social-cultural knowledge, attitudes and practices that span the reproductive period in rural northern Ghana. Data illustrate that not only are the first few days of life critical in infant survival but also there are significant social and cultural barriers to ensuring that mothers and their newborns are cared for in a timely, evidence-based manner.

Asphyxia · Childbirth · Environmental health · Family medicine · Health care · Infant mortality · Political science · Population · Pregnancy · Qualitative research · Child Nutrition and Water Access · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Nursing · Pediatrics