title: Midwives' perceptions and experiences of health promotion practice in Ghana.
abstract: BACKGROUND
  This research explores midwives' perceptions and experiences of health promotion practice in Ghana.
  
  
  METHODS
  A qualitative descriptive exploratory design was used in order to gain better insight into midwives' perceptions and experiences of health promotion practice. A total of 21 midwives took part in the study. Data were collected by individual in-depth semi-structured interviews. Thematic analysis was used to analyse the transcript.
  
  
  RESULTS
  Five dominant themes emerged from the interview transcripts, namely: health promotion as education, health promotion activities, the value of health promotion, client participation, and midwives' barriers to promoting health. Although midwives underscored the importance of health promotion to their work, their reports indicated that, in practice, midwives mostly delivered health education and behaviour change communication rather than health promotion. The midwives expressed the view that by way of their close association with women, they were in a better position to influence women's health. Health promotion activities engaged by the midwives included weight management, healthy eating, infection prevention, personal hygiene, counselling on family planning, and screening for hazardous and harmful substance use such as alcohol and smoking. All the midwives mentioned that clients participated in their health promotion activities. Factors that were identified by the midwives to enhance client participation were trust, attitude of the midwife, building rapport, creating enabling environment, listening and paying attention to clients and using simple language. The barriers to health promotion identified by the midwives included time, stress, culture, lack of training and inadequate health educational materials.
  
  
  CONCLUSIONS
  Midwives in this study had limited knowledge about health promotion, yet could play a significant role in influencing health; thus there is a need for on-going in-service training for midwives to focus on health promotion.
authors.affiliation: Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana eowusuaddo@yahoo.co.uk.
authors.forename: Ebenezer
authors.initials: E
authors.lastname: Owusu-Addo
mesh_terms: D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008880:Midwifery; D011247:Pregnancy; D036301:Qualitative Research
keywords: behaviour change; education (including health education); health promotion; participation; qualitative