Considerable efforts are being made to improve access to maternal health care in order to reduce maternal
mortality rate in Ghana. However, the use of non-formal care during pregnancy and childbirth among women
still remain high in some communities. In this study, we investigated factors influencing the use of nonformal
health care by women during pregnancy and childbirth, when formal health care services are readily
available, in a centrally-located low-income neighborhood in Accra, the capital city of Ghana. Twelve (12)
focus group discussions and six (6) individual interviews were conducted with ninety (90) women who had at
least one child, to examine factors determining the use of non-formal health care during pregnancy and child
birthing. Traditional birth attendant and spiritual care were identified as forms of non-formal maternal health
care utilized by pregnant women. Cost of seeking formal health care, the belief that traditional birth
attendants and spiritual churches could offer spiritual protection during childbirth, fear of cesarean delivery,
the belief in the potency of herbal medicine in sustaining pregnancy, lack of antenatal clinic attendance, and
influence of parents on site of delivery were reasons for preference for non-formal health care by pregnant
women. The findings point to the need to look beyond formal physical access, the need for government
absorbing full cost of maternal care for women who cannot pay, to accommodating women’s religious beliefs
and integrate non-formal health care providers into the formal health care system in low income urban
communities in Ghana.