The gross inequalities in heath that we see within and between countries present a challenge to the world (Marmot 2005). The issue is the thrust of Millennium Developmental Goals, enable to reduce inequalities in health across the world there is need for a third major thrust that is commentary to development of health systems and relief of poverty (Marmot 2005). Social determinants of health are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities, the unfair and avoidable differences in heath status seen within and between countries (WHO 2015). It is hard to relate just one health determinant to my country Ghana’s reproductive health issues. Ghana suffers from what most underdeveloped countries experience which is poor reproductive health issues in just about all aspects. When factoring all these aspects into reproductive health issues it includes things such as contraceptive use, Sexually transmitted infections (STI’s), unsafe abortion acts, unintended pregnancies, adolescent sexual and reproductive health, spread of HIV/AIDS, maternal health. I think that all these health determinants in general play a specific role in reproductive health issues such as early life, stress, food/nutrition, social exclusion, and etc.
The determinant I want to focus on with reproductive issues is Early life in correlation with unintended pregnancies and maternal health. Observational research and intervention studies show that the foundations of adult health are laid in early child hood and before birth (WHO 2013). Poor circumstances during pregnancy can lead to less than optimal fetal development via a chain that may include deficiencies in nutrition during pregnancy, maternal stress, a greater likelihood of maternal misuse of drugs and alcohol, insufficient exercise, and inadequate prenatal care (WHO 2013). Unintended pregnancies may carry serious consequences for women and their families, including possible unsafe abortion, delayed prenatal care, poor maternal mental health, reduced mother/ child relationship quality, poor developmental outcomes for children, physical abuse and violence against women, increased risk of low birth weight of babies as well as increases maternal morbidity and mortality ( Eliason 2014). The high rate of unintended pregnancies in Sub-Saharan Africa, including Ghana, attests to poor access to reproductive health care especially family planning, inadequate reproductive health rights and low empowerment of women (Eliaosn 2014). Women in developing countries die each year from complications of pregnancy and childbirth. In sub-Saharan Africa, poor living conditions and inadequate nutrition and health care, coupled with high fertility rates that often expose women of all ages to high risk of pregnancy related illness and death (Graham 1991). In Ghana it is estimated that over 130,000 Ghanaians, mostly women and children die each year due to preventable causes and majority of such deaths are related to maternal and child mortality (Addai 2000). Maternal health services is said to play a vital role in achieving improved reproductive outcomes in various societies. In Ghana there is extremely poor access to health care services and resources. A policy that was mentioned and definitely a huge part of the solution in, The Solid Facts of Social Health Determinants states that, providing good nutrition, health education, health and preventive care facilities, adequate social and economic resource before first pregnancies, during pregnancies, and in infancy to help improve development and reduce the risk of disease and malnutrition (WHO 2013).
Patience Aseweh Abor, Gordon Abekah‐Nkrumah, Kojo Sakyi, Charles K.D. Adjasi, Joshua Abor, (2011) “The socio‐economic determinants of maternal health care utilization in Ghana”, International Journal of Social Economics, Vol. 38 Iss: 7, pp.628 – 648
Eliason, Sebastian, et al. “Determinants of unintended pregnancies in rural Ghana.” BMC Pregnancy and Childbirth 14 (2014): 261. Academic OneFile. Web. 14 Aug. 2015.