By Betty B. Blay Ackah. Communications co-ordinator, Maternal Health Channel, Accra, Ghana
“If you eat an egg, your child will become a thief.”
“If you eat snails, your child’s mouth will be slippery.”
“The use of enemas make babies stronger.”
These are just a few of the common misconceptions about pregnancy the research team of the Maternal Health Channel (MHC) encountered at the Anomabo Health Centre in the Central Region. The maternity unit of the Centre is accessed by approximately 28,500 inhabitants from 13 communities.
These misconceptions are not only derived from mis-education about pregnancy, but also social and cultural beliefs and practices which sometimes result in dire health consequences. For instance, keeping away from certain foods, which might be the cheapest and most readily available options to provide much needed vitamins in a given community, could negatively affect the pregnancy and the very lives of pregnant women. One pregnant viewer of the Maternal Health Channel asked if she should stop eating mangoes because her community said it was bad for her. There is no scientific research that supports this however. Thus, in the case where a pregnant woman has no access to any other fruits but mangoes, she causes herself more harm than good by refusing to eat them based on social misconceptions.
Showing us around the centre, Midwife Hannah Dzeagu told us that misunderstandings about the stages of pregnancy and of family planning in general, are the causes of many of the complicated cases she sees at the centre. A principal problem is men who discourage their partners from seeking the family planning services available at Anomabo, because it is believed that contraception is only appropriate for the promiscuous and thus frowned upon by society. This same fear of stigmatization from society is what contributes to many fatal botched abortions. For fear of opening themselves up to social criticism, many women choose to furtively ingest unknown herbal abortive.
The stark reality is that the appalling state of maternal healthcare in Ghana is a consequence of myriad factors. Several medical centres in Ghana, especially the ones in rural areas, lack essential facilities and supplies; focusing on our case study, the Anomabo Health Centre lacks a sufficient supply of oxygen. There is no laboratory, causing patients to travel as far as to other towns like Biriwa for laboratory services.
The constant lack of blood necessitates transfers of patients to the District Hospital in Salt Pond. Patient transfers are further complicated by a lack of adequate transportation; the clinic has no ambulance and the roads surrounding the town are rough and of poor quality, as well as overly congested on market days. In order to combat transportation issues, the health workers at Anomabo encourage pregnant women to have the phone number of a taxi driver on in case they have a medical emergency. Also, the clinic has an agreement with the national public transport members who are awarded yearly if they transport women in labour from remote villages to health centres.
There is an obvious need for a concerted revamping of the entire health system; adequately equipping major hospitals in every district of the country, distribution of health personnel, addressing the dichotomy between traditional midwives and professional health personnel, etc. However, an intervention in maternal health necessarily has to be multifaceted, thus also responding to negative cultural practices and beliefs; those destructive cankers which are imbedded in the social consciousness and contribute significantly to the deplorably high rate of maternal mortality in Ghana.
The importance of foregrounding the local realities in health interventions cannot be underestimated. Behaviours exhibited by members of a particular community have to be analysed and addressed within the socio-cultural backgrounds which inform them. In MHC’s programmes 10, “Profile of Dr. Sylvia Deganus”, we paid tribute to Dr. Deganus, one of only 5 female gynaecologists in Ghana’s public health system and an award-winning doctor who practices at the Tema General Hospital. She recalled a pregnant woman who refused to undergo a crucial caesarean section. She died as a consequence.
With her socio-cultural perception of surgery as a curse, her mother had told her that she would not be touched by a knife in the name of Jesus. It was with this firm faith that she subsequently lost her life. There have also been lives lost because pregnant women in emergencies would be taken first to the spiritualist for hours of prayers before they are rushed to the hospital. In some cases, they bleed to death while still being prayed on. The point here is to underline the importance of an in-depth understanding of any community’s religious, social and cultural perceptions, before one is able to appropriately address the attitudes and behaviours borne out of the community in question.
Midwife Dzeagu expressed a desire to publicly educate her constituency on family planning and maternal health in general. “Since there are no radio stations within our catchment areas, we only educate them when they come for antenatal services. Sometimes we organize community durbars to educate them, but we are yet to start this year.” Hannah explained that she wanted a fleet of vehicles not only to provide effective transportation for women in labour to get the medical attention they need, but to support a travelling team of educators, who could dispel the myths and misconceptions that lead to tragedy.
Footnote: The Maternal Health Channel Television and Radio series in Ghana is an engaging media platform which informs and educates on maternal health issues in a bid to engender stimulating debates and advocacy for better and more sustainable maternal health care in Ghana. A principal mandate of the programme is to mainstream issues concerning maternal health in national discourse, we seek solutions to save lives