Exclusive breastfeeding practices and associated factors among lactating mothers of infants aged 6-24 months in the Kumasi Metropolis, Ghana.

OBJECTIVE: In spite of the benefits associated with exclusive breastfeeding practice (EBP), the practice remains low in Ghana. This study investigates prevalence and factors associated with EBP among lactating mothers of infants aged 6-24 months in Metropolitan Kumasi. Cross-sectional hospital-based data were collected at 5 health facilities from 160 randomly sampled lactating mothers. Multivariate logistic regressions were performed to determine factors associated with EBP. RESULTS: The prevalence of EBP was 50.6%. The study revealed that mothers aged 30-49 years (AOR = 1.948; 95% CI [1.146-3.310]), with normal delivery (AOR = 1.824; 95% CI [0.863-2.467]) and those who were unemployed (AOR = 1.202; 95% CI [0.557-2.593]) and without sore nipple (AOR = 1.890; 95% CI [1.534-3.484]) were significantly more likely to practise exclusive breastfeeding. The study further found that respondents with 3-4 deliveries were 0. 492 times significantly less likely to practise exclusive breastfeeding (AOR = 0.492; 95% CI [0.274-0.886]). The study has established the primacy of socio-demographic and health-related factors such as mothers' age, employment status, number of deliveries (parity), mode of delivery and sore nipples in explaining EBP among lactating mothers. We recommend that policy on exclusive breastfeeding should consider multiple socio-demographic and health-related factors, especially, those associated with EBP.

Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana.

The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise "pull" and "push" relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The "pull factors"-perceived benefits in TRM use vis-à-vis the "push factors"-perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the "pull factors," viz.-personal health beliefs, desire to take control of one's health, perceived efficacy, and safety of various modalities of TRM-were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.

How intra-familial decision-making affects women's access to, and use of maternal healthcare services in Ghana: a qualitative study.

BACKGROUND: There is some evidence to suggest that within the household, family and community settings, women in sub-Saharan Africa often have limited autonomy and control over their reproductive health decisions. However, there are few studies that examine how intra-familial decision-making power may affect women's ability to access and use maternal health services. The purpose of this paper is to examine how intra-familial decision-making affects women's ability to access and use maternal health services. METHODS: We conducted 12 focus group discussions and 81 individual interviews with a total of 185 expectant and lactating mothers in six communities in Ghana. In addition, 20 key informant interviews were completed with healthcare providers. Attride-Stirling's thematic network analysis framework was used to analyse the data. RESULTS: Findings suggest that decision-making regarding access to and use of skilled maternal healthcare services is strongly influenced by the values and opinions of husbands, mothers-in-law, traditional birth attendants and other family and community members, more than those of individual childbearing women. In 49.2%, 16.2%, and 12.4% of cases in which women said they were unable to access maternal health services during their last pregnancy, husbands, mothers-in-law, and husband plus mothers-in-law, respectively, made the decision. Women themselves were the final decision-makers in only 2.7% of the cases. The findings highlight how the goal of improving access to maternal healthcare services can be undermined by women's lack of decision-making autonomy through complex processes of gender inequality, economic marginalisation, communal decision-making and social power. CONCLUSION: Interventions to improve women's use of maternity services should move beyond individual women to target different stakeholders at multiple levels, including husbands and mothers-in-law.