SOCIO-CULTURAL FACTORS ASSOCIATED WITH MATERNAL MORTALITY AND MORBIDITY IN THE AYAWASO SUBMETROPOLITAN DISTRICT

ABSTRACT Studying women within the socio-cultural context in which they live to identify factors influencing the level of maternal mortality and morbidity, constitute an important component of the effort to help minimize death or disability from complications of pregnancy and child birth. Maternal mortality in the Ayawaso Sub-Metro district increased from 4 in 2006 to 14 in 2007, pregnancy related complications rose from 817 in 2006 to 1521 in 2007(Annual Report of Ayawaso Sub-Metro, 2007). The study objective was to identify socio-cultural factors associated with maternal mortality and morbidity. This cross sectional survey sampled 368 women aged 15-49 years. Structured questionnaire, In-depth interview (IDI) and Focus group discussion (FGD) were used as data collection techniques. Some of the key findings were knowledge about causes of maternal mortality and these were (Haemorrhage (30%), retained placenta (25%), abortion complications (25%) and prolonged labour (20%)). Secondly, 84% of respondents were able to identify danger signs in pregnancy, delivery and after delivery. Some of the danger signs identified were: non movement of fetus, bleeding, abdominal pains, severe headache, hypertension, abdominal lie of fetus, multiple pregnancy and anaemia. In addition, beliefs and cultural practices play significant role in the community and this puts pregnant women at a higher risk, for instances prolonged labour is attributed to infidelity and curse, swelling in pregnancy traditionally signifies a baby boy and 70.4% of respondents mentioned this.  Similarly, a woman delivering at the health facility is expected to spend less time for (instance less than three hours) in order to prove that she is a real woman. Decision making in relation to reproductive health issues is solely the responsibility of the husbands and this was said by, 78.9 % of 151 married women. Also some of the cultural practices pertaining in the community were as follows: blowing a bottle to expel placenta, using concoctions to stimulate contraction and boasting HB levels, keeping mother and baby indoors for a period after delivery. Among 207 mothers who delivered at the health facility 40.5% did not visit the health facility for at least a two weeks and the reasons given were solely cultural practice. Poor attitude of health professionals was also identified to influence the decision to seek care. Diseases identified during pregnancy and after child birth were hypertension, infection, haemorrhage, anaemia and malaria.

The study concluded that women’s reproduction is influence by culture and traditional practices which puts them at a higher risk during pregnancy, delivery and after birth. The study therefore suggests all hands on deck approach in reducing maternal mortality and morbidity, that is traditional leaders should help modify some cultural and traditional practices that might be harmful to pregnant women, community groups should encourage pregnant women to improve upon their health seeking behaviour by visiting the health facility whenever they identify danger signs and health professionals should make health facility customer friendly by being receptive and opening up to clients.