Women's autonomy in maternal healthcare decision-making in urban Ghana

Enhancing the decision-making autonomy of women 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 Southern countries. This study explored women's autonomy in decision-making over their maternal healthcare in Ghana. The authors used a mixed method design, collecting data through a survey of pregnant and lactating mothers from private and public health centers in Madina, a suburb of Accra in the Greater Accra Region. They also gathered qualitative data from nurses/midwives, the women and their partners. The study identified a clear dominance of men over women in taking 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 women dominated decision-making process.