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A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition

Overview of attention for article published in BMC Pregnancy and Childbirth, December 2014
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (55th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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2 tweeters

Citations

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99 Dimensions

Readers on

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502 Mendeley
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Title
A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition
Published in
BMC Pregnancy and Childbirth, December 2014
DOI 10.1186/s12884-014-0425-8
Pubmed ID
Authors

John Kuumuori Ganle, Michael Parker, Raymond Fitzpatrick, Easmon Otupiri

Abstract

BackgroundTo reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country.To explore health system factors that inhibit women¿s access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free.MethodsWe conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling¿s thematic network analysis framework to analyze and present our data.ResultsWe found that in addition to limited and unequal distribution of skilled maternity care services, women¿s experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana.ConclusionOur findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that discourage access and use.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 502 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Ethiopia 1 <1%
Malawi 1 <1%
Ghana 1 <1%
Kenya 1 <1%
United States 1 <1%
Unknown 497 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 124 25%
Student > Bachelor 58 12%
Researcher 56 11%
Student > Ph. D. Student 41 8%
Student > Postgraduate 40 8%
Other 78 16%
Unknown 105 21%
Readers by discipline Count As %
Medicine and Dentistry 129 26%
Nursing and Health Professions 102 20%
Social Sciences 66 13%
Economics, Econometrics and Finance 10 2%
Business, Management and Accounting 9 2%
Other 63 13%
Unknown 123 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 December 2014.
All research outputs
#2,096,202
of 4,691,600 outputs
Outputs from BMC Pregnancy and Childbirth
#706
of 1,163 outputs
Outputs of similar age
#64,390
of 155,138 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#31
of 54 outputs
Altmetric has tracked 4,691,600 research outputs across all sources so far. This one has received more attention than most of these and is in the 52nd percentile.
So far Altmetric has tracked 1,163 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.0. This one is in the 34th percentile – i.e., 34% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 155,138 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.
We're also able to compare this research output to 54 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.