University of Ghana http://ugspace.ug.edu.gh UNIVERSITY OF GHANA TRADITIONAL BELIEFS, PRACTICES AND MATERNAL HEALTH IN THE SEKYERE SOUTH DISTRICT OF GHANA BY JOYCE SERWAA OPPONG 10205037 THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF MASTER OF PHILOSOPHY DEGREE IN SOCIOLOGY JULY, 2015 University of Ghana http://ugspace.ug.edu.gh DECLARATION I hereby declare that except for references to other people‘s works, which have been duly acknowledged, this work is the result of my own research. I also declare that to the best of my knowledge this thesis has never been presented in whole or part for the award of another degree elsewhere. .................................................. ….………………..…….... JOYCE SERWAA OPPONG DATE STUDENT ………………………. ………………………........ DR. STEPHEN AFRANIE DATE SUPERVISOR ……………………….. …………………………..... DR. DAN-BRIGHT S. DZORGBO DATE SUPERVISOR i University of Ghana http://ugspace.ug.edu.gh DEDICATION To the woman whose womb cradled me as a child, the bosom that embraced the whining baby, whose warm hearth fed me and to all the women in the village where lies buried my umbilical cord, I say… Ayekoo! ii University of Ghana http://ugspace.ug.edu.gh ACKNOWLEDGEMENT I am grateful to the Lord God Almighty for his faithfulness. I hereby acknowledge the indispensable help of my supervisors Dr. Dan-Bright S. Dzorgbo and Dr. Stephen Afranie for encouraging academic conscientiousness but never dictating the course of my study as well as for their dedication while supervising my work. I also acknowledge with sincere appreciation and heartfelt gratitude the immense contribution made by my family, most importantly my mother Janet Asare and siblings Mr. Michael Yaw Owusu and Alfred Agyei Kensah. In addition, I am grateful to Uncle Mr Richard Asare Kodua whose unrelenting support has brought me this far. To the trio of friends whose support have always come in handy these last few years- Mavis Boatemaa, Portia Seim, and Mr. David Adomako Kotei-I am most grateful. Also, but for the support of Stephen Kwaku Agyei of Agona Government Hospital, this work would not have been successful. Furthermore, I wish to express my appreciation to the administrator, the doctors and midwives of Seventh-day Adventist Hospital, Asamang Ashanti and Seventh-day Adventist Hospital, Wiamoase Ashanti for taking time off their tight schedules to attend to me. Finally, I wish to commend the Administrator and staff of the Sekyere South District Health Directorate and the staff of the Sekyere South District Assembly for releasing information about the district for my research. iii University of Ghana http://ugspace.ug.edu.gh ABSTRACT The research studies the traditional beliefs and practices about pregnancy, childbirth and postpartum periods in the Sekyere South District of Ashanti Region. Its objectives are to document the social meanings attached to pregnancy and childbirth, to examine the beliefs and practices about pregnancy, childbirth and postpartum periods and to interrogate the practices that promote maternal health in the community. Applying principally a qualitative approach, a total of thirty five respondents, guided by saturation theory, were interviewed. A multistage sampling was used in sampling twenty-seven members of the community which comprised people who have ever been parents, pregnant women and elderly people. In addition, eight key informants - medical doctors, midwives and traditional birth attendants were sampled through purposive sampling and snowball sampling. The study reveals that preference for female child was emphasised among the indigenes because the female child will procreate and perpetuate the matrilineage. Also, persistent spiritual, behavioural and dietary practices were held by the indigenes during pregnancy, childbirth and postpartum periods. Prominent among the traditional practices was the patronage of the services of traditional birth attendants by women seeking to conceive and pregnant women. In addition, foods such as ripe plantain, roasted plantain, snails, okra, etc. were tabooed. However, these traditional beliefs and practices are janus-faced in that though some were considered deleterious to the health of the women and foetuses by health workers, the indigenes considered other practices as helpful in averting and reducing maternal and neonatal morbidity or death. For instance, as a behavioural restriction, pregnant women were cautioned not to fight or eat in public to avoid the evil eyes of spirits and people who seek to harm their babies. Moreover, families played great role in taking care of the mothers and babies which constituted a form of social capital, iv University of Ghana http://ugspace.ug.edu.gh ensuring the safety of the mothers and babies and preventing postnatal depression during the postpartum periods. The study recommended among others a healthy reconciliation of both the biomedical model of health care and the traditional system of health care. Also, the need to strengthen the health insurance policy of the country to prevent women who seek the help of untrained traditional birth attendants and herbalist was noted. v University of Ghana http://ugspace.ug.edu.gh TABLE OF CONTENTS Content Page DECLARATION ........................................................................................................................ i DEDICATION............................................................................................................................ii ACKNOWLEDGEMENT ......................................................................................................... iii ABSTRACT ..............................................................................................................................iv TABLE OF CONTENTS ..........................................................................................................vi LIST OF TABLES.....................................................................................................................xi LIST OF FIGURES .................................................................................................................. xii LIST OF ACRONYMS ........................................................................................................... xiii CHAPTER ONE ...................................................................................................................... 1 GENERAL INTRODUCTION............................................................................................... 1 1.1 Background to the study .................................................................................................. 1 1.2 Problem Statement ........................................................................................................... 4 1.3 General Objective ............................................................................................................ 7 1.4 Specific Objectives .......................................................................................................... 7 1.5 Research Approach .......................................................................................................... 7 1.6 Purpose of the study ......................................................................................................... 8 1.7 Significance of the Study ................................................................................................. 8 1.8 Organization of the Study ................................................................................................ 9 1.9 Definition of Concepts ..................................................................................................... 9 vi University of Ghana http://ugspace.ug.edu.gh CHAPTER TWO ................................................................................................................... 13 LITERATURE REVIEW ..................................................................................................... 13 2.1 Introduction .................................................................................................................... 13 2.2. Traditional Beliefs and Cultural Practices during Pregnancy, Childbirth and Postpartum period ................................................................................................................ 13 2.2.1 Social Meanings attached to Pregnancy and childbirth .............................................. 14 2.2.2 Secrecy ........................................................................................................................ 19 2.2.3 Spirituality Surrounding Pregnancy/Childbirth/Postpartum Period ........................... 22 2.2.4 Food Taboos/Dietary Practices ................................................................................... 27 2.2.5 Behavioural Restrictions/Other Practices ................................................................... 32 2.2.6 Cord Management....................................................................................................... 37 2.2.7 Culture of Pain ............................................................................................................ 39 2.3.1 Theoretical Framework ............................................................................................... 40 2.3.2 Adopting Cultural Construct as a Theory ................................................................... 44 2.3.3 Social Facts ................................................................................................................