BACKGROUND:
Despite global efforts to reduce maternal mortality, Ghana continues to record high maternal and neonatal deaths, particularly in rural districts such as Nkwanta North. Skilled Birth Attendants (SBAs) play a critical role in improving pregnancy outcomes and are central to Ghana’s national strategy for reducing maternal mortality. However, SBA utilisation remains low in many rural areas, with numerous women still delivering at home with unskilled attendants, even though free maternal healthcare is available nationwide. A complex interplay of factors, including poverty, limited access to quality care, entrenched cultural beliefs, gender roles, and negative experiences or perceptions of disrespectful care, continues to shape maternal health decisions. Increasing the use of SBAs and making childbirth safer in such settings requires a nuanced understanding of these determinants to inform targeted, culturally sensitive interventions.

OBJECTIVES:
To explore the barriers and facilitators to SBA uptake in Nkwanta North and co-design community-led interventions that can increase utilisation and improve outcomes.

METHODS:
A qualitative, interpretive approach was employed, involving five focus group discussions with mothers (both SBA and TBA users), partners, health workers, TBAs, and community leaders. Thematic analysis is ongoing, with emerging themes organised using the Socio-Ecological and Three Delays Models to guide understanding of multilayered influences.

RESULTS:
While analysis is currently ongoing, it will be completed by the time of the conference where findings will be shared.

CONCLUSIONS:
Multiple interrelated factors influence SBA uptake in Ghana. Interventions should prioritise female education, respectful maternity care and community-based strategies that promote autonomy and women’s decision-making power.

KEY MESSAGE:
Targeted, data-informed policies are needed to address the structural and behavioural barriers limiting SBA use in Ghana. Poster session 4 (Group B)