Maternal mortality remains high in Ghana, a lower middle income country, although
maternal health indicators have improved over the past 20 years. Between 1990 and
2003, the maternal mortality rate decreased from 740 per 100,000 live births to 503 per
100,000, and then to 451 per 100,000 live births in 2008 (Ghana Statistical Service
(GSS) et al., 2009). This slow pace reduction of maternal mortality was inadequate for
Ghana to attain its Millennium Development Goals (MDGs) target of 185 maternal
deaths per 100,000 live births by 2015 (Ministry of Health et al., 2011). As in Ghana
maternal mortality also remains high in many other Low and Middle Income
Countries (LMICs) with little evidence of progress (Bhutta et al., 2010, Lozano et al.,
2011, Waage et al., 2010, 2008).
Over the years, policy makers at national level have formulated a wide range
of public policies and programmes to increase financial and geographical access to
maternal care; space child birth; provide essential obstetric care; expand midwifery
coverage; and make equipment and health facilities available and many more to
improve maternal health outcomes and reduce maternal deaths in Ghana
(Government of Ghana, 2006, Ministry of Health, 2011b, Ministry of Health, 2007,
Ministry of Health et al., 2011, Witter et al., 2009, Ofosu-Amaah, 1981).
These national level policy decisions are of great importance for maternal
health because they influence which concrete measures are put in place and how
they are implemented to improve maternal health outcomes. This thesis aims to
advance our understanding of how maternal health policy decisions are made at
national level in Ghana, and present potential lessons for policy actors out of these
explanations and understanding to engage in making better informed policy
decisions to improve maternal health.