Skip to main content

Advertisement

Log in

Accessibility and Utilisation of Maternal Health Services by Migrant Female Head Porters in Accra

  • Published:
Journal of International Migration and Integration Aims and scope Submit manuscript

Abstract

Accessibility to maternal health care by marginalised groups, such as poor migrant women, has remained an issue of concern in Ghana. While a number of studies have been conducted on the livelihoods of migrant female head porters (Kayayei) in cities in Southern Ghana, there is little understanding of their accessibility and utilisation of maternal health services. This paper examines the challenges that the migrant female head porters encounter in the process of seeking maternal health care in Accra. The data were collected through a questionnaire survey on a sample of 70 female head porters and in-depth interviews with key informants and some of the Kayayei. The findings indicate that the factors affecting accessibility to maternal health services by the Kayayei are unavailability of health facilities in the slums where Kayayei live, low-income levels, high cost of maternal health care, long queues and waiting times at modern health facilities, and the perception that traditional medicines are adequate for protecting pregnant women and their babies. It was therefore suggested that government should increase the number of health facilities and strengthen the National Health Insurance Scheme to enhance access to health care by this vulnerable and poor group of people as well as increase health educational campaigns.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Agarwal, S., Aitah, M., Apt, N., Grieco, M., Kwakye, E.A. & Turner, J. (1994). Bearing the weight: the Kayayoo, Ghana’s working child. Paper presented at UNICEF Conference on the Girl Child, Delhi. February 1994. www.transport-links.org/transportlinks/filearea/publications/1_664_PA1322_1994.pdf. Accessed 10 Jul 2013

  • Akabzaa, T., Aseidu, A., Badu, A., Quartey, P. & Akuoni, S. (2010). Migration and economic development in Ghana. Centre for Migration Studies, Migration Studies Technical Paper Series. Technical paper No. 1. Accra: Woeli Publishing Services

  • Angel-Urdinola, D., Cortez, R., & Tanabe, K. (2008). Equity, access to healthcare services and expenditure on health in Nicaragua., Unpublished HNP Discussion Paper

  • Awumbila, M., & Ardayfio-Schandorf, E. (2008). Gendered poverty, migration and livelihood strategies of female porters in Accra, Ghana. Norwegian Journal of Geography, 62(3), 171–179.

    Google Scholar 

  • Awumbila, M., Manuh, T., Quartey, P., Tagoe, C.A. & Bosiakoh, T. A., (2008). Migration country paper (Ghana). Unpublished paper prepared as part of the African Perspectives on Human Mobility Programme

  • Awumbila, M., Alhassan, O., Badasu, D., Bosiakoh, T., & Dankyi, E. (2011). Sociocultural dimensions of migration in Ghana. Centre for Migration Studies. Migration Studies Technical Paper Series. Technical Paper No. 3. Accra: Woeli Publishing Services.

    Google Scholar 

  • Bryman, A. (2001). Social research methods. London: Oxford University Press.

    Google Scholar 

  • Carballo, M. (2006). Female migrants, reproductive health, HIV/AIDS and rights of women. In UNFPA/IOM, Female migrant: bridging the gaps throughout the life cycle. New York: UNFPA.

    Google Scholar 

  • Carballo, M., Grocutt, M., & Hadzihasanovic, A. (1996). Women and migration: a public health issue. World Health Statistics Quarterly, 49(2), 158–164.

    Google Scholar 

  • Carballo, M., & Nerukar, A. (2001). Migration, refugees and health risks. Emerging Infectious Diseases, 7(3 Suppl.), 556–560.

    Article  Google Scholar 

  • Clarke, P. (2009). Understanding the experience of stroke: a mixed-method research agenda. The Gerontologist, 49, 293–302.

    Article  Google Scholar 

  • Colins, T. (2003). Globalisation, global health, and access to healthcare. International Journal of Health Planning and Management, 18, 97–104.

    Article  Google Scholar 

  • Creswell, J.W., Plano Clark, V.L., Gutman, M.L. & Hanson, W.E. (2003). Advance mixed methods research designs. In A Tashakkori & C. Teddlie (eds.), Hand book of mixed methods in social and behavioral research (pp.209–240). London: Sage Publications.

  • Dias, S., & Quintal, F. (2008). Cultural dynamics in mental and reproductive health of immigrant women in Portugal. European Journal of Public Health, 18(suppl. 1), 48.

    Google Scholar 

  • Devine, F., & Heath, S. (1999). Sociological research methods in context. Basingstoke: Palgrave Macmillan.

    Google Scholar 

  • Dugbazah, J.E. (2007). Gender, migration and rural livelihood in Ghana. A case of the Ho District. A Thesis submitted by the University of Birmingham in partial fulfilment for the Degree of Doctor of Philosophy. Centre for West African Studies, School of Historical Studies, Faculty of Arts, University of Birmingham, UK

  • Gertler, P.J., Locay, L. & Sanderson, W. (1988). Are user fees regressive? The welfare implications of health care financing proposals in Peru. In P. Gertler, L. Locay, W. Sanderson, A. Dor, and J. van der Gaag (Eds.) Health care financing and demand for medical care. LSMS working paper No. 37. Washington, D.C.: The World Bank 48

  • Global Press Institute (2011). Maternal mortality rates remain high in Ghana. News report by Lilly Mensah, May 5, 2011

  • Joshi, A. R. (1994). Maternal schooling and child health: preliminary analysis of the intervening mechanisms in rural Nepal. Health Transition Review, 4, 1–28.

    Google Scholar 

  • Kollapen, J. (2009). Access to health care services: public inquiry. South Africa: South African Rights Commission.

    Google Scholar 

  • Kwankye, S.O., Anarfi, J.K., Tagoe, C.A. & Castaldo A. (2007). Coping strategies of independent child migrants from Northern Ghana to Southern cities. Development Research Centre on Migration, Globalisation and Poverty. Arts C-226. University of Sussex Brighton BN1 9SJ

  • Leslie, J., & Gupta, G. R. (1989). Utilisation of formal services for maternal nutrition and health care in the third world. ICRW: Washington D.C.

    Google Scholar 

  • Litchfield, J., and Waddington, H. (2003) Migration and poverty in Ghana: evidence from the Ghana Living Standards Survey. Sussex Migration Working Paper No.10, Brighton, U.K.: Sussex Centre for Migration Research.

  • Machado, M.C., Fernandes, A., Padilla B. Dias, S. Gomes, I. & Oliveira da Silva, M. (2009). Maternal and child healthcare for immigrant populations. International Organisation for Migration (IOM). A background paper. Developed within the framework of IOM project “Assisting Migrants and Communities (AMAC): Analysis of Social Determinants of Health and Health inequalities”. International Organisation for Migration (IOM). Regional Liaison Office for the European Union. Brussels. Belgium

  • Mayor, S. (2001). Poorest women 20 times more likely to die in childbirth. British Medical Journal, BMJ Vol. 323 (7325):1324.

  • Mekonnen, Y., & Mekonnen, A. (2002). Utilisation of maternal health care services in Ethiopia. Ethiopian Health and Nutrition Research Institute. Ethiopia: Addis Ababa.

    Google Scholar 

  • Miller, P. (2005). Barriers preventing access to healthcare services for women in Rural Samoa. A Thesis presented to the Faculty of the Centre for International Studies, Ohio University. Retrieved from https://etd.ohiolink.edu/

  • Navaneetham, K. & Dharmalinam, A. (2000). Utilisation of maternal health care services in South India

  • Onokerhoraye, A. G. (1999). Access and utilisation of modern healthcare facilities in the petroleum producing region of Nigeria: the case of Bayelsa State. A Research Paper no. 162. Takemi Program in International Health. Harvard School of Public Health. 666 Huntington Avenue. Boston, MA 02115 (617) 4326686.

  • Opare, J. A. (2003). Kayayei: the women head porters of southern Ghana. Journal of Social Development in Africa, 18(2), 33–49.

    Google Scholar 

  • Owusu, G., Agyei-Mensah, S., & Lund, R. (2008). Slums of hope and slums of despair: mobility and livelihoods in Nima, Accra’. Norsk Geografisk Tidsskrift, 62, 180–190.

    Article  Google Scholar 

  • Penchansky, R. & Thomas, W. (1981). The concept of access to medical care: definition and relationship to consumer satisfaction. Medical Care, 19(2): 127–140.

  • Peters, D.H., Garg, A., Bloom, G., Walker, D.G., Brieger, W.R. & Rahman, M.H. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences1136:161–171. Doi: 10.1196/annals.1425.011

  • Puigros, M., Volta, C., Eseverri, I., Colomer, J., & Barnusell, J. (2008). Immigrant pregnancy and neonatal morbidity. Anales des Pediatrias (Barcelona), 68(6), 596–601.

    Article  Google Scholar 

  • Quaicoe, R. (2005). Woe of the Kayayoo’. Accra: The Daily Graphic.

    Google Scholar 

  • Ramachandran, L. (1989). The effect of antenatal and natal services on pregnancy outcome and health of the mother and child. Journal for Family Welfare, 35(5), 34–46.

    Google Scholar 

  • Ramasundram, S. (1995). Causes for the rapid fertility decline in Tamil Nadu: a policy planners perspective. Demography India, 24(1), 13–21.

    Google Scholar 

  • Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1994). The health belief model and HIV risk behaviour change. In R. J. DiClemente & J. L. Peterson (Eds.), Preventing AIDS: theories and methods of behavioral interventions (pp. 5–24). New York, NY: Plenum Press.

    Chapter  Google Scholar 

  • Sahn, D. E., Younger, S. D., & Genicot, G. (2003). The demand for healthcare services in Rural Tanzania. Oxford Bulletin of Economics and Statistics, 65(2), 0305–9049.

    Article  Google Scholar 

  • Savedoff, W. D. (2009). A moving target: universal access to healthcare services in Latin America and the Caribbean. Inter-American Development Bank. Research Department. Working Paper #667. Washington, D.C. 20577.

  • Sibeon, R. (2004). Rethinking social theory. London: Sage Publications.

    Google Scholar 

  • Sword, W., Watt, S., & Krueger, P. (2006). Postpartum health services needs and access to care experience of immigrants and Canadian-born women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(6), 717–727.

    Article  Google Scholar 

  • Tashakkori, A., & Teddlie, C. (2010). Putting the human back in human research methodology: the researcher in mixed methods research. Journal of Mixed Methods Research, 4(4), 271–277.

    Article  Google Scholar 

  • Teye, J. K. (2012). Benefits, challenges, and dynamism of positionalities associated with mixed methods research in developing countries: evidence from Ghana. Journal of Mixed Methods Research, 6(4), 379–391.

    Article  Google Scholar 

  • Tong, C., Chen, J., & Cheng, L. (1999). Survey of causes of induced abortion in Shanghai. Shanghai Medical Journal, 22(6), 345–353.

    Google Scholar 

  • WHO (2011a). Maternal health. http://www.who.int/gho/maternal_health/en/. Accessed 10 Nov 2011

  • WHO (2011b). Making pregnancy safer. http://www.who.int/making_pregnancy_safer/topics/maternal_mortality. Accessed 12 Nov 2012

  • Wyss, K. (2003). Access of the urban poor and vulnerable to healthcare in Africa. Switzerland: Swiss Agency for Development and Cooperation.

    Google Scholar 

  • Yaro, J. A., Codjoe, S. N. A., Agyei-Mensah, S., Darkwah, A., & Kwankye, S. O. (2011). Migration studies technical paper series 2. Centre for Migration Studies: Legon. ‘Migration and Population Dynamics: Changing Community Formations in Ghana’.

    Google Scholar 

  • Yeboah, M. A., & Appiah-Yeboah, K. (2009). An Examination of the Cultural and SociocutEconomic Profiles of Porters in Accra, Ghana. Nordic Journal of African Studies, 18(1), 1–21.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gerald A. B. Yiran.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yiran, GS.A., Teye, J.K. & Yiran, G.A.B. Accessibility and Utilisation of Maternal Health Services by Migrant Female Head Porters in Accra. Int. Migration & Integration 16, 929–945 (2015). https://doi.org/10.1007/s12134-014-0372-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12134-014-0372-2

Keywords

Navigation