title: Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana.
abstract: Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.
authors: a Global REACH , University of Michigan Medical School , Ann Arbor , MI , USA.
authors: Mira L
authors: ML
authors: Gupta
authors: b Navrongo Health Research Centre , Navrongo UE/R , Ghana.|c Department of Public Health , Monash University School of Medical and Health Sciences , Selangor Darul Ehasan , Malaysia.
authors: Raymond Akawire
authors: RA
authors: Aborigo
authors: d Department of Social and Behavioral Science , University of Ghana School of Public Health , Legon , Ghana.
authors: Philip Baba
authors: PB
authors: Adongo
authors: a Global REACH , University of Michigan Medical School , Ann Arbor , MI , USA.
authors: Sarah
authors: S
authors: Rominski
authors: b Navrongo Health Research Centre , Navrongo UE/R , Ghana.
authors: Abraham
authors: A
authors: Hodgson
authors: e Department of Maternal and Child Health , University of North Carolina School of Public Health , Chapel Hill , NC , USA.
authors: Cyril M
authors: CM
authors: Engmann
authors: a Global REACH , University of Michigan Medical School , Ann Arbor , MI , USA.|f Department of Medical Education , University of Michigan Medical School , Ann Arbor , MI , USA.
authors: Cheryl A
authors: CA
authors: Moyer
mesh_terms: D003657:Decision Making; D005260:Female; D020793:Gatekeeping; D005869:Ghana / Q000453:epidemiology; D000066502:Grandparents / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D016901:Intergenerational Relations; D007407:Interviews as Topic; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data*; D016488:Medicine, African Traditional / Q000523:psychology / Q000639:trends*; D008880:Midwifery; D009035:Mothers / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011209:Power, Psychological; D011247:Pregnancy; D012423:Rural Health; D014933:Women's Rights / Q000639:trends*
keywords: Ghana; grandmothers; health-seeking behaviour; maternal and child health; power dynamics