Abstract

This paper examined how couples' awareness of obstetric signs and complications inform intra-household decision-making towards care-seeking. The data were generated from twelve focus groups and twenty-four individual interviews involving women who were receiving maternity care and their husbands in the Yendi Municipality, Awutu-Senya West and Chereponi Districts in Ghana. Quota sampling and snowballing were used to reach the participants. The study classified couples as knowledgeable or less knowledgeable based on their level of awareness of key signs of obstetric signs and complications. Most knowledgeable couples took joint decisions devoid of cultural and gender influences. Their decisions were reached based on their knowledge about obstetric signs/symptoms or complications and their implications for maternal and neonatal health. There were some level of gender equality and female autonomy amongst the knowledgeable in decision-making. However, decisions made by less knowledgeable couples were male-dominated, culture and gender-driven embedded in health beliefs and traditional gender norms. The decision-making by the less knowledgeable was associated with delays due to socio-cultural structures within the household and community. Though decisions by knowledgeable couples showed positive attitudes towards care-seeking as compared with the less knowledgeable, the data indicate that awareness of maternity conditions does not necessarily translate into positive clinic attendance because it may be influenced by cultural beliefs and gender roles to determine the need for clinical care as well as the type of care-seeking decision taken by couples. Healthcare practitioners should consider carrying out needs assessment for maternal counselling messaging for couples. Education on pregnancy and related complications as well as their implications for maternal and neonatal health is essential to facilitate informed decisions and prompt maternal clinic attendance. For positive