Women’s Autonomy in Maternal Healthcare Decision-Making in Urban Ghana

Abstract

Enhancing women’s decision-making autonomy in developing countries constitutes one of the recognised approaches to improving maternal healthcare service utilisation. The inability of women to make decisions about their health, the lack of universal health insurance, and inadequate health facilities are contributing factors to high maternal mortality rates in many countries in the developing world. This study explored women’s decision-making autonomy over maternal healthcare in Ghana. The authors used a mixed method design, collecting quantitative data through a survey of 163 pregnant and lactating mothers from private and public health centres in Madina, a suburb of Accra in the Greater Accra Region. They also gathered qualitative data from four nurses/midwives and 40 women and their partners. The study identified a clear dominance of men over women in making maternal health decisions, explained mainly by cultural, financial and religious factors. It also identified two other decision-making processes influenced by economic factors: a balanced or democratic decision-making process and a women-dominated decision-making process. The paper concludes that there is a need for a change in cultural norms and stereotypes, particularly concerning the supply side of health services and the factors driving individuals to seek quality and appropriate maternal health care. Presently, these decisions are heavily influenced by cultural and economic patriarchal relations.