title: Women's experiences of seeking reproductive health care in rural Ghana: challenges for maternal health service utilization.
abstract: OBJECTIVE
  This paper is a report of part of a larger study exploring rural Ghanaian women's experiences of seeking reproductive health care. The aim of this part of the study was to describe rural women's perspectives on their experiences in seeking reproductive care from professional nurses.
  
  
  BACKGROUND
  Nurses' relationships with childbearing women have been linked to women's reproductive healthcare-seeking behaviour and service utilization. However, few researchers have studied women's perspectives on their relationships with nurses when seeking health care. In Ghana, the high rates of maternal mortality raise concerns about a number of factors, including nurses' relational practices.
  
  
  METHODS
  Data were collected in 2007 with a convenience sample of 27 Ghanaian women via in-depth interviews, focus groups and participant observation. Women's ages ranged from 15 to 49 years. The translated and transcribed data were thematically analyzed.
  
  
  RESULTS
  Healthcare providers' relational practice influenced women's healthcare-seeking behaviours. Major themes from women's stories were: (a) experiences of intimidation and being scolded, (b) experiences of limited choices, (c) receiving silent treatment, and experiences of lack of privacy. Women emphasized the importance of their relationships with nurses and the impact of these relationships on their healthcare-seeking.
  
  
  CONCLUSIONS
  Nursing education in Ghana must place emphasis on basic relational practices. Structural changes to health clinics and routine nursing practices are necessary to create conditions for privacy to address women's health concerns. Women's perspectives must be considered for service improvement. Further research is needed to examine nurses' perspectives on relational care.
authors.affiliation: Community, Culture and Global Studies, Irving K. Barber School of Arts & Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.
authors.forename: Vida Nyagre
authors.initials: VN
authors.lastname: Yakong
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Rush
authors.forename: Joan
authors.initials: J
authors.lastname: Bassett-Smith
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
authors.forename: Carole
authors.initials: C
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D003906:Developing Countries; D005260:Female; D005869:Ghana; D006297:Health Services Accessibility / Q000592:standards; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008427:Maternal Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008428:Maternal Mortality; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D011209:Power, Psychological; D011247:Pregnancy; D018907:Privacy; D036301:Qualitative Research; D019035:Rural Health Services / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult