Abstract:
Background: Skilled delivery reduces maternal and neonatal mortality. Ghana has put in place measures to reduce
geographical and financial access to skilled delivery. Despite this, about 30% of deliveries still occur either at home or are
conducted by traditional birth attendants. We, therefore, conducted this study to explore the reasons for the utilization
of the services of traditional birth attendants despite the availability of health facilities.
Method: Using a phenomenology study design, we selected 31 women who delivered at facilities of four traditional
birth attendants in the Northern region of Ghana. Purposive sampling was used to recruit only women who were
resident at a place with a health facility for an in-depth interview. The interviews were recorded and transcribed into
Microsoft word document. The transcripts were imported into NVivo 12 for thematic analyses.
Results: The study found that quality of care was the main driver for traditional birth attendant delivery services.
Poor attitude of midwives, maltreatment, and fear of caesarean section were barriers to skilled delivery. Community
norms dictate that womanhood is linked to vaginal delivery and women who deliver through caesarean section do not
receive the same level of respect. Traditional birth attendants were believed to be more experienced and understand
the psychosocial needs of women during childbirth, unlike younger midwives. Furthermore, the inability of women to
procure all items required for delivery at biomedical facilities emerged as push factors for traditional birth attendant
delivery services. Preference for squatting position during childbirth and social support provided to mothers by traditional
birth attendants are also an essential consideration for the use of their services.
Conclusion: The study concludes that health managers should go beyond reducing financial and geographical access
to improving quality of care and the birth experience of women. These are necessary to complement the efforts at
increasing the availability of health facilities and free delivery services.
