An Exploration of Cultural Beliefs and Attitudes towards Prenatal and Postnatal Health of Ghanaian-Born Women in America

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An Exploration of Cultural Beliefs and Attitudes towards Prenatal and Postnatal Health of Ghanaian-Born Women in America

Category: Book Report

Subcategory: Nursing

Level: PhD

Pages: 4

Words: 1100

An Exploration of Cultural Beliefs and Attitudes towards Prenatal and Postnatal health of Ghanaian Women Born in America: A Literature Review
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An Exploration of Cultural Beliefs and Attitudes towards Prenatal and Postnatal health of
Ghanaian Women Born in America: A Literature Review
Overview of Maternal Health Services in America
The major maternal health care services are implemented through the Maternal and Child Health Block Grant Program. This initiative is USA’s oldest federal-state partnerships that aim to improve the health and well-being of women including mother and children. Currently, 5 million US Dollars have been made available annually, to run such program. The maternal healthcare initiatives in the United States include access to quality health care by affluent and low economic families. There has been assistance in the reduction of infant mortality with access to comprehensive prenatal and postnatal care for women. Health assessments and diagnostic follow-ups with treatment interventions have been significantly increased (Berg et al., 2010, 1302-1309). There is also a provision for toll-free hotlines and assistance for seeking services for pregnant women who are eligible for Medicaid scheme.
Overview of Maternal Health Services in Ghana
There are various initiatives implemented by the government of Ghana to improve maternal healthcare (Ghana Statistical Service, Ghana Health Service & ICF Macro, 2009). Free maternal health services, repositioning family planning structures, training, and awareness, and effective deployment of reproductive and child healthcare staff are some of such initiatives (Hill, 2007, 1311-1319). A safe motherhood task force has been created, and the number of trained midwives has been significantly increased. Midwives are specifically trained on partograph to improve confidence, reduction of prolonged labor, decrease in a number of still births and reducing the need for caesarean sections (Alexander & Korenbrot, 1995, 103-120).
A High Impact Rapid Delivery (HIRD) approach is also initiated to reduce maternal and child mortality as a complementary step. Other initiatives include Ghana VAST survival program, Safe Motherhood Program, Prevention of Maternal Mortality Program (PMMP). Another program called Emergency Obstetrics and Neonatal Care is also implemented, but the required resources including midwives and infrastructure are not adequate for translating the success of the program (www. ghanaweb.com).
Ghanaian Demographic figures & Maternal Mortality Rates
During the past two decades, although there has been a decrease in maternal mortality rate, however, the target of reducing maternal mortality by three-quarters within 2015 has not been achieved. The institutional mortality rates have decreased from 216 per 100000 live births to 164 per 100000 live births during the period from 1990 to 2010. Presently the figures of mortality are 110 per 100000 live births. However, the target was to achieve the figures of 54 per 100000 live births in 2015 (www. ghanaweb. com).
AWHONN Standards of Maternal Care
The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) operates as a non-profit organization to ensure and promote maternal health. The AWHONN guidelines provide a protocol for effective staffing to ensure quality care. The skills and experience of nurses trained on AWHONN guidelines provides an effective and safe labor-delivery unit (Medoff-Cooper, 2005, 666-671).
AWHONN provides evidence-based guidelines for implementation through nurses. The areas that are covered includes technical knowledge of labor induction, monitoring of heart rate in fetus, ensuring care for late preterm infants, correct methods of breastfeeding, counseling for Human Papilloma Virus, and appropriate delivery of healthcare to patients who are in their second stage of labor (Association of Women’s Health, Obstetric and Neonatal Nurses, 2009).
WHO guidelines and standards of Maternal Care
The World Health Organization (WHO) has created the Standards for Maternal and Neonatal Care, as a part of WHO Integrated Management of Pregnancy and Childbirth Care (IMPAC) policy. These standards provide the necessary guidance and recommendations for various countries to improve the health and survival of mothers and their newborn children during prenatal, perinatal and postnatal periods (World Health Organization &UNICEF, 2010).
The areas that have been stressed in such guidelines include maternal immunization against tetanus, prevention and management of sexually transmitted diseases (STDs) and reproductive tract infections, prevention of syphilis from mother to their child, Prevention of Congenital Rubella Syndrome and Neural Tube defects. There are also provisions for effective antenatal care that aims in the prevention of malaria, nutritional supplementation guidelines on Iron and folic acid, and finally recommendations for emergency preparedness related to birth (World Health Organization &UNICEF, 2010).
Current trend and alternative childbearing practices
Due to an increase in healthcare costs in hospitals and a shortage of nursing staff, family-centered maternal care homes, community birth centers, and home delivery through midwives are being encouraged all across the globe (Filippi, 2006). Midwives are important resources for ensuring maternal health during antenatal period (Graham, Bell & Bullough, 2001, 97-129). This is done to reduce the episodes of preterm birth and need for cesarean sections (Nodine & Hastings-Tolma, 2012).
Cultural Beliefs and Value Systems among ethnic groups in Ghana
The cultural beliefs and value system in Ghana provides adequate stress on religion and God. Abortion and family planning is considered as an act of crime and pregnancy is considered a gift of God. Expected mothers are prevented from taking honey as it is considered to block the uterine canal and cause premature death of the baby (Aforbu, 1994).
Beliefs, Cultural Attitudes, and Practices Regarding Pregnancy
The major beliefs and practices include a restriction on foods and restriction of locus of control (Akazili et al., 2011, 62-73). There is an increased dependency in herbal remedies all across the globe. Women and their family members have strong belief on the persons involved in the locus of control, and infertile or impotent individuals are kept away from the care of expected mothers (Toure, 2012). Cultural Foods, Taboos and Nutrition during Pregnancy
Honey, as discussed earlier, is a taboo in various cultures. Certain herbs from the palm tree are used by the priests for the expected mother (Addo, Marquis, & Lartey, 2006). Since groundnuts and sugars interacted with the herb, they are refrained for intake (Ardayfio-Schandorf, 1994). Further, there is a belief that vegetables are better than meat during the antenatal period. In Ghana, women are restricted from sweeping as it is considered that such sweeping will sweep away the soul of the baby. Women are also encouraged to take more fruits and proteins (Chebere, 1994). Beliefs and Knowledge about Conception
Conception is considered a blessing in almost every culture across the world. It is viewed as a holy event and a reward for the family, due to God’s grace. Infertility and impotence are considered in the context of a woman only, and male counterparts are not held responsible across various cultures even in this 21st century (Gage, 2007, 1666-1682). Most people are unaware about the episodes of azoospermia or oligospermia. Shedding of sperm outside the female genital tract is considered a crime in Ghanaian culture (Aforbu, 1994).
Beliefs about pregnancy complications – Diabetes Gestational diabetes is viewed in various cultures (Glazer et al., 2004, 733-737) as an inherited disease and develops in expected mothers( de-Graft Aikins et al., 2014), who goes outside for employment (Chu et al., 2007, 2070-2076).
Beliefs about labor complications – Epidurals & failure to Achieve Vaginal Delivery
A general belief for pain and use of epidurals is viewed as a curse of God. It is considered that an expecting mother must have committed a certain sin, due to which, she is unable to achieve a normal delivery, and have to be dependent on cesarean sections (Clarke et al., 2008, 1-105). The general masses are not at all aware of the anatomical complexities of the female genital tract (Aforbu, 1994).
Beliefs about Postpartum Complications
Postpartum complications like eclampsia or infections in the baby or the mother are viewed as non-compliance to cultural and religious beliefs during the antenatal periods (Aforbu, 1994).
Traditional Practices during Pregnancy
The traditional practices include offering prayers to God, especially women who are facing complexities during the antenatal period. Lack of proper medical intervention has led to increased mortality (Benbow& Maresh, 1998, 1431-1432). Women are discouraged to wear high heeled shoes and must bathe two times a day (Chebere, 1994).
Beliefs and attitudes About Miscarriage & Stillbirths
Miscarriages and stillbirths are often considered to be caused by supernatural powers. It is thought that such situation arises when an expected mother disobeys God. Further, the common belief that prevails includes dreaming of an affair with another man displeases God and activates a demon who causes such miscarriages and stillbirths (Aforbu, 1994).
References
Association of Women’s Health, Obstetric and Neonatal Nurses. (2009). Standards for professional nursing practice in the care of women and newborns (7th ed.). Washington, DC.
Akazili, J., Livesy, A., Hodgson, A., & James, P. (2011). “Is there any relationship between antenatal care and place of delivery?” Findings from rural northern Ghana. Afr J Health Sci, 18(1-2):62–73
Addo, A. A., Marquis, G. S., & Lartey, A. A. (2006). Dietary intakes of Ghanaian pregnant and lactating women living in HIV affected communities. Paper presented at the Africa Nutrition Epidemiology Conference, 15–18 August, Accra, Ghana
Alexander, G, & Korenbrot, C. (1995). “The Role of Prenatal Care in Preventing Low Birth Weight”. The Future of Children. Low Birth Weight, 5 (1): 103–120.
Aforbu, E. (1994). “Family Planning Knowledge, Attitude, and Practice at Dome-Ho.” Ph.D. paper, University of Ghana, Accra.
Ardayfio-Schandorf, E.(1994). Family and Development in Ghana. (Accra: Ghana Universities Press). 84
Berg C, J., Callaghan, W, M., Syverson, C., & Henderson, Z. (2010). “Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol, 116:1302–1309
Benbow, A., & Maresh, M.(1998). Reducing maternal mortality: reaudit of recommendations in reports of confidential inquiries into maternal deaths. Brit Med J, 317:1431–1432
Clark, S, L., Belfort, M, A., Byrum, S, L., Meyers, J, A., & Perlin J, B. (2008). Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety. Am J Obstet Gynecol, 199:1–105.
Chu, Susan Y.; Callaghan, W.M.; Kim, S.Y.; Schmid, C.H.; Lau, J.; England, L.J.; & Dietz,
Mellitus”.Diabetes Care 30 (8): 2070–2076
Chebere, M. (1994). “A Study on Cultural Practices Related to Childbearing in Nakpala.” Ph.D. paper, University of Ghana, Accra. de-Graft Aikins, A., Awuah, R. B., Pera, T.,
Mendez, M., & Ogedegbe, G. (2014). “Explanatory models of diabetes in poor urban Ghanaian communities. Ethnicity and Health”. Advance online publication. doi:10.1080/13557858.2014.921896
Filippi, V.( 2006). “Maternal health in poor countries: the broader context and a call for action”. The Lancet, 368: 1535–1541
Gage, A. (2007). “Barriers to the utilization of maternal health care in rural Mali”. Social Science & Medicine, 65: 1666–1682
Ghana Statistical Service (GSS), Ghana Health Service (GHS), & ICF Macro (2009). Ghana Demographic and Health Survey, 2008. Accra, Ghana: Authors
Glazer, N; Hendrickson, A, Schellenbaum, G, & Mueller, B.. (2004). “Weight Change and the Risk of Gestational Diabetes in Obese Women”. Epidemiology, 15 (6): 733–737
Graham, W., Bell, J., & Bullough, C. (2001). “Can skilled attendance at delivery reduce maternal mortality in developing countries?” Studies in Health Services Organization and Policy, 17:97–129
Hill., K. (2007). Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet, 370:1311–1319
Medoff-Cooper, B. (2005). “The AWHONN Near-Term Infant Initiative: A Conceptual Framework for Optimizing Health for Near-Term Infants”. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 34: 666–71
Nodine, P.,& Hastings-Tolsma, M. (2012). “Maternal obesity: Improving pregnancy outcomes.”. MCN American Journal of Maternal Child Nursing, 37: 110–115., cited in Santrock, John W (2013). Life-Span Development (14 ed.). McGraw Hill
Toure, K. (2012). “Positioning women’s and children’s health in the African Union Policy making: A policy analysis”. Global Health. Cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill.
 World Health Organization & UNICEF. (2010). “Countdown to 2015 decade report (2000–2010): taking stock of maternal, newborn and child survival”. Geneva: WHO and UNICEF. Mode of access: www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID=201104