Perceived Social Support and Access to Postpartum and Newborn Care in Northern Ghana: Exploring Women’s Experiences Using the Three Delays Model

The role of social support in health outcomes has recently garnered significant interest from most researchers. However, there is limited literature on the role of social support networks as social support providers during the postpartum period on mother-newborn access to care in low-resource settings. Some studies have examined the association between social support and other maternal health outcomes, such as depression. However, no study has explicitly reviewed postpartum women’s perceived social support and social influence as critical functional roles of women’s social networks (WSN) on postpartum and newborn access to care. The first 1000 days of life for a mother and her child are crucial, yet most preventable maternal and newborn deaths continue to occur (WHO, 2019; WHO, 2022a). This thesis examined this relationship using the three-delays model (Thaddeus & Maine, 1994) and the conceptual framework of social networks and social support (Heaney & Israel, 2008), as well as social networks and health (Berkman et al., 2000).

In this thesis, I assessed postpartum women’s perceived social support and the social influence of WSN on postpartum and newborn access to care among 48 women who were participants in an ongoing Randomized Controlled Trial – The Focused-Postpartum Care (Focused-PPC) project for women in Tamale, Ghana. The women were within one year of giving birth. Data were collected using semi-structured interview guides and audio-recorded in Dagbani and English Language across all four study sites: Bagabaga, Choggu, Kalpohini, and Kanvili Health Centers. The data obtained were transcribed into English and analyzed in Atlas.ti.23 for codes and idiosyncratic themes using the qualitative thematic data analysis method (Braun & Clarke, 2012). In addition, participants’ demographic data were analyzed using Stata/BE.

The main results showed five (5) major thematic areas that broadly represented the findings. They include 1.Composition of Women’s Social Support Networks and Reason for Identification; 2. Women’s Structural Relationship with In-laws; 3. Influence of Social Networks on Decision Making; 4. Barriers to Accessing Care; and 5. Support in Accessing Care, including a. Satisfaction with Support and b. Major Social Support Needs. Findings show the importance of integrating women’s social support networks into postpartum and newborn care.