title: Examining antenatal health literacy in Ghana.
abstract: OBJECTIVE
  To explore Ghanaian pregnant women's understanding and recognition of danger signs in pregnancy, birth preparedness and complication readiness, and their understanding of newborn care.
  
  
  METHODS
  An exploratory, qualitative study design was used.
  
  
  METHODS
  Data were gathered through six focus group discussions with 68 pregnant women attending antenatal care at a busy urban hospital in Ghana. Qualitative and descriptive data were analyzed using SPSS version 21. Health literacy was used as the guiding framework to analyze the qualitative data. Data were analyzed in the content domains of (a) understanding and recognition of danger signs in pregnancy, (b) preparedness for childbirth, (c) understanding and recognition of danger signs in the newborn, and (d) appropriate and timely referral.
  
  
  RESULTS
  Women in this study identified danger signs of pregnancy and in the newborn, but had difficulty interpreting and operationalizing information they received during antenatal care visits, indicating that health education did not translate to appropriate health behaviors. Cultural beliefs in alternative medicine, lack of understanding, and prior negative encounters with healthcare professionals may have led to underutilization of professional midwives for delivery and health services.
  
  
  CONCLUSIONS
  Women in this study exhibited low health literacy by incorrectly interpreting and operationalizing health education received during antenatal care. With limited health literacy, pregnant women cannot fully comprehend the scope of services that a health system can provide for them and their families.
  
  
  CONCLUSIONS
  Achieving the greatest impact with limited time in antenatal care is a challenge. Since antenatal care is widely available to pregnant women in Ghana, it is vital to reexamine the way antenatal education is delivered. Pregnant women must receive health information that is accurate and easy to understand in order to make informed health choices that will improve maternal and child health.
authors.affiliation: Rho, Associate Professor, School of Nursing, Division of Health Promotion and Risk Reduction, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Jody R
authors.initials: JR
authors.lastname: Lori
authors.forename: Chin Hwa Y
authors.initials: CH
authors.lastname: Dahlem
authors.forename: Jacqueline V
authors.initials: JV
authors.lastname: Ackah
authors.forename: Richard M K
authors.initials: RM
authors.lastname: Adanu
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D017144:Focus Groups; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006786:Hospitals, Urban; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D055815:Young Adult
keywords: Africa; Antenatal care; Ghana; focused antenatal care; health literacy