Women’s Contributions to Biomedical Healthcare in Ghana: A Focus on Obuasi

Prestige and Passion

Existing literature claims that most women enter into the health profession as a result of passion to care for humanity (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). Findings from our study justify the above claim as women in Obuasi had naturally discharged roles as nurses, midwives and lay caregivers since time immemorial. Most of our interviewees hinted that choosing their professions as nurses and midwives were borne out of their compassion for humanity and the will to serve others. In an interview, a participant explained:

Similarly, another interviewee explained how she forfeited her trade in order to follow her passion. She argued that:

From our studies, out of the fifteen nurses, thirteen (86.6%) of them believed that nursing profession is a call to serve humanity. As a prerequisite, people ‘called by God’ need to develop the passion to serve humanity in the area of meeting their medical needs. One nurse claimed that, after schooling, her parents had limited funds to aid her to further her studies; and due to the interest she had in the profession, she joined the mission’s work to be trained as a nurse (Rahamat, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Additionally, she hinted that:

Our findings simulate the information within the literature. From the literature, it has been argued that most nurses and midwives were naturally born with the attitude and character exhibited by Florence Nightingale; the care for humanity (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). It is argued that about 60% of nurses quit work within their first year due to the lack of compassion for the profession and towards people in particular (Tye, 2015Tye, J. (2015) “10 Leadership Lessons from Florence Nightingal” Available at: https://www.connectionculture.com/post/10-leadership-lessons-from-florence-nightingale [Accessed 5 May 2020]. ).

The prestige attached to the nursing and midwifery professions is believed to be a motivating factor. While all the midwives attached prestige to the profession, our study showed that out of the fifteen (15) nurses included in the study, ten (10) (66.7%) of them also associate prestige to their profession. Also, all the two doctors and five pharmacy assistants attach such prestige to their respective professions. On the attachment of prestige to the medical profession, most of our respondents claimed it was as a result of the fact that health workers deal with human lives and as such are seen as “God-sent.” They are regarded as God-sent in critical points of life. A patient hinted:

In their study, Beach and her contemporaries argued that respect is frequently regarded as an important dimension in the profession of medicine (Beach et al., 2007Beach, M. C., Duggan, P. S., Cassel, C. K. and Geller, G. (2007) “What Does ‘Respect’ Mean: Exploring the Moral Obligation of Health Professionals to Respect Patients.” Journal of General Internal Medicine, 22 (5), pp. 692-695. doi: https://doi.org/10.1007/s11606-006-0054-7.). Similarly, Adu-Gyamfi and Brenya’s study found out that some of these professional health workers choose their profession based on the respect the populace attach to these professions. Writing in the latter part of the twentieth century, Gostin and his peers put forward the argument that commanding respect will aid the development of natural or instinctive preference from patients and people in general (Gostin, 1995Gostin, L. O. (1995) “Informed Consent, Cultural Sensitivity and Respect for Persons”. Journal of American Medical Association, 272 (10), pp. 844-845. doi: https://doi.org/10.1001/jama.1995.03530100084039. ). Significantly, it has been contended that this form of respect imposes a distinctive moral feature upon the responsibilities of physicians and health workers (Beach et al., 2007Beach, M. C., Duggan, P. S., Cassel, C. K. and Geller, G. (2007) “What Does ‘Respect’ Mean: Exploring the Moral Obligation of Health Professionals to Respect Patients.” Journal of General Internal Medicine, 22 (5), pp. 692-695. doi: https://doi.org/10.1007/s11606-006-0054-7.).

Education

The literature on education in Africa argues that, few women during the colonial era and at the dawn of independence had attained formal education with the ability to read and write; they were specifically trained to be nurses and midwives (Akiwumi, 1971Akiwumi, A. (1971) Higher Education for Nurses. Accra: Ghana Universities Press.; Adu-Gyamfi and Brenya 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). An 82-year-old patient hinted that:

This finding is consistent with information from the literature on women and education which puts forward the argument that, women were marginalized when it comes to the issue of education in Africa and Ghana in particular (Akiwumi, 1971Akiwumi, A. (1971) Higher Education for Nurses. Accra: Ghana Universities Press.; Manuh, 1991Manuh, T. (1991) “Women and their Organizations During the Convention People’s Party.” In: K. Arhin, ed., Life and Work of Kwame Nkrumah: Papers of a Symposium. Accra, New Jerssey: Sedco/Africa World Press, pp. 101-127.; Adu-Gyamfi and Brenya 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). This notwithstanding, few women received formal education and were subsequently employed as teachers, nurses, and clerks whose employment was subject to termination upon marriage and/or pregnancy (Manuh, 1991Manuh, T. (1991) “Women and their Organizations During the Convention People’s Party.” In: K. Arhin, ed., Life and Work of Kwame Nkrumah: Papers of a Symposium. Accra, New Jerssey: Sedco/Africa World Press, pp. 101-127.). With few women attaining formal education during the era under review, Manuh (1991)Manuh, T. (1991) “Women and their Organizations During the Convention People’s Party.” In: K. Arhin, ed., Life and Work of Kwame Nkrumah: Papers of a Symposium. Accra, New Jerssey: Sedco/Africa World Press, pp. 101-127. and Robertson (1984)Robertson, C. C. (1984) “Formal or Nonformal Education? Entrepreneurial Women in Ghana.” Comparative Education Review, 28 (4), pp. 639-658. described women’s access to education during the era as generally inadequate and limited. Significantly, a study published in the latter part of the second half of 1980s argued that it was only during the 1970s that girls received equal opportunities to be represented in formal education with their fellow men (Robertson, 1984Robertson, C. C. (1984) “Formal or Nonformal Education? Entrepreneurial Women in Ghana.” Comparative Education Review, 28 (4), pp. 639-658. ).

Significantly, at the inception of midwifery training in the country, only girls with better education were recruited to be trained (Robertson, 1984Robertson, C. C. (1984) “Formal or Nonformal Education? Entrepreneurial Women in Ghana.” Comparative Education Review, 28 (4), pp. 639-658. ). This notwithstanding, women have been provided with the avowed opportunity to take up spaces in the health sector to address the question of limited health workers. As a result, the health sector has recorded the recruitment of many women to act as nurses and midwives to aid the provision of healthcare in the Obuasi area (Diana, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ).

As economies grow, girls’ education has been reported to grow at a faster rate than boys (Heath and Jayachandran, 2017Heath, R. and Jayachandran, S. (2017) “The Causes and Consequences of Increased Female Education and Labor Force Participation in Developing Countries.” The Oxford Handbook of Women and the Economy. doi: https://doi.org/10.1093/oxfordhb/9780190628963.013.10 ). Also, it has been argued that people receive education to fill available job spaces (Heath and Jayachandran, 2017Heath, R. and Jayachandran, S. (2017) “The Causes and Consequences of Increased Female Education and Labor Force Participation in Developing Countries.” The Oxford Handbook of Women and the Economy. doi: https://doi.org/10.1093/oxfordhb/9780190628963.013.10 ). In an interview, it was reported that the provision of education for women and the expansion of the health profession have influenced women to grab these opportunities of becoming providers of healthcare (Regina, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ).

Africa, and the world at large, have limited health workers. According to Lori et al. (2012)Lori, J. R., Rominski, S., Richardson, J., Agyei-Baffour, P., Kweku, N. E. and Gyakobo, M. (2012) “Factors Influencing Ghanaian Midwifery Students’ Willingness to Work in Rural Areas: A Computerized Survey.” International Journal of Nursing Studies, 49 (7), pp. 834-841. doi: https://doi.org/10.1016/j.ijnurstu.2012.02.006 , in their quest to address the challenges of limited healthcare providers, Ghana’s Ministry of Health (MoH) aimed at improving nursing and midwifery practice by expanding and opening new nursing and midwifery schools. This opportunity has motivated a larger portion of the women population in the community and Ghana as a whole to enroll in these schools to take up spaces in the health profession (Diana, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). The requirements to become a nurse is relatively relaxed than most programmes run in health training institutions. In recent times, there are other avenues that health professionals utilize to improve upon their training and certification. In Ghana, general nurses are required to spend at least two years in Colleges to earn diploma, or four years to earn bachelor’s nursing degree (Diana, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Concerning midwifery, it is a three-year post-secondary programme after which one obtains a diploma (Agyei-Baffour et al., 2013Agyei-Baffour, P., Rominski, S., Nakua, E. K., Gyakobo, M. and Lori, J. R. (2013) “Factors that Influence Midwifery Students in Ghana when Deciding where to Practice: A Discrete Choice Experiment.” BMC Medical Education, 13 (1), pp. 1-6. doi:https://doi.org/10.1186/1472-6920-13-64 ). Also, doctors -both general and specialists- are required to obtain a professional doctorate degree (MD) before they are appointed to serve in health institutions.

From a different perspective, based on the findings of Heath and Jayachandran (2017)Heath, R. and Jayachandran, S. (2017) “The Causes and Consequences of Increased Female Education and Labor Force Participation in Developing Countries.” The Oxford Handbook of Women and the Economy. doi: https://doi.org/10.1093/oxfordhb/9780190628963.013.10 , we argue that increase in female enrollment in formal education has increased their numbers in the health sector. Significantly, in Obuasi, the limited number of health workers in the community has caused several women to enroll to take up responsibilities in biomedical practice (Mary, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ).

Our studies in the health centers have specifically revealed that, the number of women in the healthcare sector of the community is satisfactory vis-à-vis the information from the literature which argues that women have been marginalized in the area of health and education (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ; Akiwumi, 1971Akiwumi, A. (1971) Higher Education for Nurses. Accra: Ghana Universities Press.). Comparatively, a study in China has revealed that aside the large number of women in the country, women have achieved parity, with the potential of achieving superiority compared to their male counterparts in professional and technical occupations (To, 2015To, S. (2015) China’s Leftover Women: Late Marriage among Professional Women and its Consequences. London: Routledge.). The debate above suggests that, the provision of equal opportunities for women and men in the area of education has caused a rise in the number of women being trained to become midwives and nurses. Going beyond the discourse, the expectation has been whether there could be much women in other spheres of the medical profession including pharmacy, surgery, and oncology among others (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ).

Job Security and Evasion of Unemployment

The issue of rampant unemployment in Ghana and Obuasi in particular is not a recent issue (Regina, interview, 2019). Within the literature, unemployment stands as a major problem which threatens the globe and Africa in particular (Jahoda, 1982Jahoda M. (1982) Employment and Unemployment. Cambridge: Cambridge University Press.; Johnson-Saylor, 1984Johnson‐Saylor, M. T. (1984) “Unemployment and Health: Issues in a Primary Care Nursing Practice.”Public Health Nursing, 1 (2), pp. 74-84.; Silva and Marcolan, 2015Silva, D. A. and Marcolan, J. (2015) “Unemployment and Psychological Distress in Nurses.” Revista Brasileira de Enfermagem, 68 (5), pp. 493-500. doi: https://doi.org/10.1590/0034-7167.2015680502i ). Significantly, aside economic problems, the issue of unemployment has tremendous impact on the individual level (Jahoda, 1982Jahoda M. (1982) Employment and Unemployment. Cambridge: Cambridge University Press.; Silva and Marcolan, 2015Silva, D. A. and Marcolan, J. (2015) “Unemployment and Psychological Distress in Nurses.” Revista Brasileira de Enfermagem, 68 (5), pp. 493-500. doi: https://doi.org/10.1590/0034-7167.2015680502i ). The literature argues that unemployment has the proclivity to result in psychosocial stress and emotional distress which can consequently result in serious mental health complications (Jahoda, 1982Jahoda M. (1982) Employment and Unemployment. Cambridge: Cambridge University Press.; Johnson-Saylor, 1984Johnson‐Saylor, M. T. (1984) “Unemployment and Health: Issues in a Primary Care Nursing Practice.”Public Health Nursing, 1 (2), pp. 74-84.; Silva and Marcolan, 2015Silva, D. A. and Marcolan, J. (2015) “Unemployment and Psychological Distress in Nurses.” Revista Brasileira de Enfermagem, 68 (5), pp. 493-500. doi: https://doi.org/10.1590/0034-7167.2015680502i ).

Significantly, most of the nurses and midwives interviewed admitted that their aim to secure a job coupled with the interest of improving their conditions and to evade unemployment informed their decision to be health practitioners. In an interview, a participant argued that, she trained to be employed into the health sector as a pharmacy assistant in order to evade unemployment. She claimed that her psyche changed during her training, and that the fear of being an unemployed youth prompted her to develop a special interest for the profession. In a similar manner, Elizabeth hinted:

The stress attached to the issue of unemployment compel individuals to take opportunities that will earn them financial resources to cope with the problems of life (Silva and Marcolan, 2015Silva, D. A. and Marcolan, J. (2015) “Unemployment and Psychological Distress in Nurses.” Revista Brasileira de Enfermagem, 68 (5), pp. 493-500. doi: https://doi.org/10.1590/0034-7167.2015680502i ). A contribution emanating from this research further suggests that people aim at pursuing career in health because they want to avoid the debilitating effect of unemployment.

From the study, it was revealed that most health workers within the Obuasi community joined the health professions in order to secure a stable job. Significantly, an informant hinted that the monthly allowances provided to nursing students by the government and the readily available jobs after school motivated her to join the health profession. A participant hinted that, women who enroll in the nursing training easily qualify to secure a place in the profession in Ghana due to inadequate health personnel in the country (Ofosu, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Similarly, an earlier study within the discourse of nursing claims that, nursing profession in Ghana is seen as a safe haven for those who want to secure jobs since they are readily posted upon completion of their studies (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). In Australia, it has been reported that the availability of jobs within the nursing profession serve as both intrinsic and extrinsic rewards for specializing in the profession (Hickey, Sumsion and Harrison, 2013Hickey, N., Sumsion, J., and Harrison, L. (2013) “Why nursing? Applying a Socio‐Ecological Framework to Study Career Choices of Double Degree Nursing Students and Graduates.” Journal of Advanced Nursing, 69 (8), pp. 1714-1724. doi: https://doi.org/10.1111/jan.12029 ). Significantly, this tendency has increased the number of nurses across the globe (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ; Hickey, Sumsion and Harrison, 2013Hickey, N., Sumsion, J., and Harrison, L. (2013) “Why nursing? Applying a Socio‐Ecological Framework to Study Career Choices of Double Degree Nursing Students and Graduates.” Journal of Advanced Nursing, 69 (8), pp. 1714-1724. doi: https://doi.org/10.1111/jan.12029 ; Ditommaso et al., 2003Ditommaso, E., Rheaume, A., Woodside, R., and Gautreau, G. (2003) “Why Students Choose Nursing: A Decade Ago, Most Nursing Students said that they Chose Nursing because they wanted to care for People and help others. Are those desires still true today?” The Canadian Nurse, 99 (5), pp. 25-29.). This notwithstanding, in our study, only a handful (17.5%) of our respondents claimed they were lured into the profession due to the financial allowances they received in school as well as the salary they anticipate during their time of work, while thirty-three (82.5%) of the participants interviewed indicated the need to serve humanity as the primary motivating factor.

Physiology and Nurturing

Nursing is looked upon as a caring, nurturing, feminine, motherly and soft profession considered ideal for women (Frimpong, 2016Frimpong, D. K. (2016) Men in Female-Dominated Profession: The Lived Experiences of Ghanaian Male Nurses in the United States. [PhD Dissertation] Lesley University. Available at: https://digitalcommons.lesley.edu/cgi/viewcontent.cgi?article=1008&context=education_dissertations [Accessed 5 May 2019]. ). Similarly, midwifery and its training, from the onset of biomedical practices, was reported to be readily accessible to women due to the fact that the nature of the job is in line with the traditional role of women (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). Significantly, the activities and practices associated with midwifery is perceived to be reserved for women (Twumasi, 1975Twumasi, P. A. (1975) Medical Systems in Ghana: A Study in Medical Sociology. Accra: Ghana Publishing Corporation. ; Adu-Gyamfi and Adjei, 2017Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing.).

Thirty-seven (92.5%) of our respondents claimed that the availability of women have proclivity to speed the recovery pace of patients. Specifically, a patient argued that “women possess empathy and other features that stimulate the fast recovery of patients” (Opanyin Kwasi Poku, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Studies on the life of Nightingale have revealed that showing your clients empathy is key to the nursing profession (Karimi and Alavi, 2015Karimi, H. and Alavi, M. N. (2015) “Florence Nightingale: The Mother of Nursing.” Nursing and Midwifery Studies, 4 (2), e29475. doi: https://doi.org/10.17795/nmsjournal29475 ). Similarly, a physician hinted that, “women are patient and have the motherly tendency to care; they take care of other people as their own wards” (Dr. Agnes, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). She further hinted that:

Women are generally perceived to be empathetic and would take care of people as if they were their own (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). A current study by Pompilio argues that “the stereotypical toxic masculinity roles claim that men are not empathic; they cannot nurture; they are not compassionate. Those roles are reserved for females” (Pompilio, 2020Pompilio, E. (2020). “Gender Roles in Nursing.” Elite Healthcare. Available at: https://www.elitecme.com/resource-center/nursing/gender-roles-in-nursing/ [Accessed 5 May 2020].). This has the tendency of discriminating against males who are enrolled in the nursing profession. A patient hinted:

It is worthy to note that not all nurses, and for that matter women nurses, possess the qualities of empathy discussed. Our conversation with patients revealed that a handful of the female nurses’ present poor reception skills coupled with poor communication skills -which has been identified by Nightingale as an influential factor in healthcare (Karimi and Alavi, 2015Karimi, H. and Alavi, M. N. (2015) “Florence Nightingale: The Mother of Nursing.” Nursing and Midwifery Studies, 4 (2), e29475. doi: https://doi.org/10.17795/nmsjournal29475 ). Pompilio (2020)Pompilio, E. (2020). “Gender Roles in Nursing.” Elite Healthcare. Available at: https://www.elitecme.com/resource-center/nursing/gender-roles-in-nursing/ [Accessed 5 May 2020]. puts forward the argument that although dissatisfied with gender-based stereotypes in nursing, some males possess more caring and physiological qualities than their female counterparts.

Women as Nurses

Historically, it has been reported that nursing in the West was a menial job reserved for women (Pompilio, 2020Pompilio, E. (2020). “Gender Roles in Nursing.” Elite Healthcare. Available at: https://www.elitecme.com/resource-center/nursing/gender-roles-in-nursing/ [Accessed 5 May 2020].). Around the 1500s, the Protestants view of women as housekeepers (Pompilio, 2020Pompilio, E. (2020). “Gender Roles in Nursing.” Elite Healthcare. Available at: https://www.elitecme.com/resource-center/nursing/gender-roles-in-nursing/ [Accessed 5 May 2020].), caring for family members and raising children entrenched the debate of women as natural nurses (Manuh, 1991Manuh, T. (1991) “Women and their Organizations During the Convention People’s Party.” In: K. Arhin, ed., Life and Work of Kwame Nkrumah: Papers of a Symposium. Accra, New Jerssey: Sedco/Africa World Press, pp. 101-127.). In a similar manner, prior to the introduction of biomedical practices in Africa, nursing care, according to Adu-Gyamfi and Brenya (2016)Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 , was a role assigned to females. There is a long-held assumption and belief that women have special talent for tending the sick (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). In contrast to this traditional notion, the first nursing school in the world is believed to have included men only and was started as far back as 250 BC in India (Pompilio, 2020Pompilio, E. (2020). “Gender Roles in Nursing.” Elite Healthcare. Available at: https://www.elitecme.com/resource-center/nursing/gender-roles-in-nursing/ [Accessed 5 May 2020].).

Within various households and communities, women are also renowned in their social roles as nurturers and caretakers of the young, aged and the sick (Pompilio, 2019). In a similar view, a respondent hinted that a nurse “is someone who cares for people; someone who helps a sick person out of his or her situation to a better and healthier situation (Rahamat, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). She added that “even as parents, all women are natural nurses in their various homes.” Within the discourses of the World Health Organization on nursing, the profession encompasses collective and autonomous care of individuals of all ages, families, groups and communities -sick or well in all settings. Globally, nurses play essential role in healthcare provision by stimulating health, preventing illness, restoring health, and lessening suffering (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). One of the interviewees, a nurse, hinted that her role as a nurse included, attending to emergency cases, managing trauma and taking care of patients (Mercy, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Similarly, a retired nurse hinted:

In an interview with a community nurse, she put forward a similar idea in relation to the normal duties of general nurses. Specifically, she added that;

Aside discharging their healthcare roles, nurses in Obuasi provide emotional support to catalyze patients’ recovery. Specifically, we argue that female nurses are the best when it comes to the provision of emotional support than their fellow men. Information from both the literature and our respondents confirmed that women have the qualities that ensure proper emotional support for people. An interviewee hinted;

Women who are community nurses -together with their male counterparts- have been at the forefront at educating the people within the remote parts of Obuasi concerning their health needs. Education of the population and the sick in particular is a core part of nursing. Flavin (2018)Flavin, B. (2018). “9 Duties of a Nurse That Might Surprise You.” Available at: https://www.rasmussen.edu/degrees/nursing/blog/surprising-duties-of-a-nurse/ reports that nurses usually educate their clients (sick or healthy) concerning “illness, procedures and symptoms they experience in the healthcare environment, as well as their plan of care upon leaving.”

Women as Midwives

Throughout history, women have been the main healthcare providers for their fellow women in Africa during childbirth and postpartum (Adu-Gyamfi, Gyasi and Poku, 2018Adu-Gyamfi, S., Gyasi, R. M., and Poku, B. A. (2018) “Women Assisting Women in a Village in Ghana: The Role of Traditional Birth Attendants in Wurubegu-Anansu.” International Journal of Body, Mind & Culture, 5 (1), pp. 46-60. doi: https://doi.org/10.22122/ijbmc.v5il.118 ). Since time immemorial, midwives have played vital roles in providing support, care and advice to pregnant women during pregnancy, labour and after birth. Within the scheme of the WHO, midwifery involves care of women during pregnancy, labor and the postpartum period as well as care of the newborn (WHO, 2018World Health Organization. (2018) World Health Organization. Available at: https://www.who.int/health-topics/maternal-health#tab=tab_1 [Accessed 21 April 2019].). Since its inception as far back as 1917 in Africa, modern midwives in Ghana played paramount roles. The initiators of the occupation saw it to be in line with the traditional role women were expected to play within society. This included attending to women during child birth (Akiwumi, 1971Akiwumi, A. (1971) Higher Education for Nurses. Accra: Ghana Universities Press.; Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). When asked who a midwife is, a respondent hinted; “a midwife is a person who provides care and support women while pregnant, during labor and after the baby is born” (Mary, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ).

Unlike the prehistoric era where midwives, popularly referred to as traditional birth attendants (TBAs), received their training from apprenticeship (Adu-Gyamfi and Adjei, 2017Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing.), modern midwives in the biomedical setting acquire their knowledge through formal education. Significantly, all the thirteen midwives included in the study revealed that they gained their training through formal education. A respondent hinted:

Midwives within Obuasi perform roles that transcend the responsibility of assisting pregnant women to deliver safely and easily. An interviewee hinted:

Similarly, an informant claimed that the activities of midwives include the advice on what food pregnant women should eat. She added:

Essentially, both earlier and current literature report that women are advised by midwives concerning the type of food they should eat, the kind of water they need to drink as well as the kind of exercises they can engage in, in order to help the baby grow well and healthier. They also help pregnant women to live a healthy life (Twumasi, 1975Twumasi, P. A. (1975) Medical Systems in Ghana: A Study in Medical Sociology. Accra: Ghana Publishing Corporation. ; Adu-Gyamfi and Adjei, 2017Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing.; Adu-Gyamfi, Gyasi and Poku, 2018Adu-Gyamfi, S., Gyasi, R. M., and Poku, B. A. (2018) “Women Assisting Women in a Village in Ghana: The Role of Traditional Birth Attendants in Wurubegu-Anansu.” International Journal of Body, Mind & Culture, 5 (1), pp. 46-60. doi: https://doi.org/10.22122/ijbmc.v5il.118 ).

In Obuasi, aside the traditional responsibilities of assisting women to safely deliver their offspring, midwives also give advice to pregnant women to regularly visit healthcare centers for checkups in order to avoid complications throughout their journey. Significantly, this role simulates the pre-historic traditional roles discharged by traditional birth attendants. During the era under review, it has been reported that TBAs regularly visited and gave guidance and necessary advice to their clients immediately after conception, through delivery to postpartum activities (Twumasi, 1975Twumasi, P. A. (1975) Medical Systems in Ghana: A Study in Medical Sociology. Accra: Ghana Publishing Corporation. ). The literature suggests that aside being specialists in obstetrics, providing women with basic healthcare during and after pregnancy, TBAs also provided advice and sex education to their clients (Adu-Gyamfi, Gyasi and Poku, 2018Adu-Gyamfi, S., Gyasi, R. M., and Poku, B. A. (2018) “Women Assisting Women in a Village in Ghana: The Role of Traditional Birth Attendants in Wurubegu-Anansu.” International Journal of Body, Mind & Culture, 5 (1), pp. 46-60. doi: https://doi.org/10.22122/ijbmc.v5il.118 ). Among other things, precolonial TBAs educated their clients on the ethics surrounding pregnancy and child-birth (Twumasi, 1975Twumasi, P. A. (1975) Medical Systems in Ghana: A Study in Medical Sociology. Accra: Ghana Publishing Corporation. ; Adu-Gyamfi and Adjei, 2017Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing.; Adu-Gyamfi, Gyasi and Poku, 2018Adu-Gyamfi, S., Gyasi, R. M., and Poku, B. A. (2018) “Women Assisting Women in a Village in Ghana: The Role of Traditional Birth Attendants in Wurubegu-Anansu.” International Journal of Body, Mind & Culture, 5 (1), pp. 46-60. doi: https://doi.org/10.22122/ijbmc.v5il.118 ).

Midwives are guided by the aim of achieving the Millennium Development Goals targeted at reducing maternal mortality in the country. In an interview with Diana, she hinted:

To emphasize, in Obuasi, midwives helped to contribute towards the achievement of the Millennium Development Goals set by the United Nations to influence health which in turn have a positive effect on development within the community and Ghana in general. Essentially, their interest was geared toward the achievement of the fourth and fifth goal: the reduction of child mortality and the improvement of maternal health respectively.

Table 2 suggests a persistent decrease in infant mortality in Ghana. In consonance with information from our respondents, the current table indicates that from 2010 to 2018, infant mortality rate has decreased from 47.5% to 34.9%, a greater contribution towards the attainment of MDGs. It is important to argue that it is the aggregate efforts of respective midwives and medical staff in respective hospitals, clinics and health centers in Ghana including Obuasi that such targets were achieved.

To ensure the attainment of these goals, midwives in the community employed the necessary measures to save the lives of their clients. As a traditional community with an avowed interest towards explaining disease causation as a natural phenomenon, midwives in Obuasi associate some complications to supernatural forces. According to Elizabeth, there are instances where a midwife would have to pray for pregnant women in labor to ensure safe delivery. She added;

The above claim clearly demonstrates that, the social causative theory is still embedded within the Obuasi community and in the scientific medical practices in particular. Similarly, in a recent study, Adu-Gyamfi and Adjei (2017)Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing. have reported instances where women could have easy and worthwhile delivery during the time of labor when they had the opportunity to apologize to family members or mothers they had offended (Adu-Gyamfi and Adjei, 2017Adu-Gyamfi, S. and Adjei, R. (2017) Traditional Medicine: Narratives from an Indigenous Population. Beau Basin: Lambert Academic Publishing.).

Workload and Inadequate Staff

An institution is required to have the right number of individuals at the right time to support its functions (Rajan, 2018Rajan, D. (2018) “Negative Impacts of Heavy Workload: A Comparative Study among Sanitary Workers.” Sociology International Journal, 2 (6), pp. 465-474. doi: 10.15406/sij.2018.02.00086 ). To that extent, the health sector is one of the most critical areas that have less capacity to perform the needed task entrusted to it. Significantly, in Africa, the required responsibilities to deliver adequate healthcare far outweighs the numerical strength of health workers (Lori et al., 2012Lori, J. R., Rominski, S., Richardson, J., Agyei-Baffour, P., Kweku, N. E. and Gyakobo, M. (2012) “Factors Influencing Ghanaian Midwifery Students’ Willingness to Work in Rural Areas: A Computerized Survey.” International Journal of Nursing Studies, 49 (7), pp. 834-841. doi: https://doi.org/10.1016/j.ijnurstu.2012.02.006 ).

Staffing shortages was found to be one of the factors challenging the operations or activities of nurses and midwives in the Obuasi community. This has become an anathema to their practice due to increased workload. In an interview with a nurse, she hinted:

Despite the recorded increase in the number of female health practitioners, the results emphasize that there is still inadequate staffing in the hospitals, especially among women medical workers in relation to the required staff to patient ratio. Several studies have addressed the shortage of staff within the healthcare sector in Ghana and Africa as a whole. From our respondents, we report that government’s negligence and lack of political will toward providing morale and support for women in biomedicine also serve as a hindrance for other women who hitherto had interest in working in the health sector. According to Adu-Gyamfi and Brenya (2016)Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 , some nurses and midwives choose to work outside the country due to inadequate morale within their profession as well as insufficient salaries (Adu-Gyamfi and Brenya, 2016Adu-Gyamfi, S. and Brenya, E. (2016) “Nursing in Ghana: A Search for Florence Nightingale in an African City.” International Scholarly Research Notices, 3, pp. 1-14. doi: https://doi.org/10.1155/2016/9754845 ). This invariably leads to limited number of nurses, hence, increasing the workload on the few that are available.

As our respondents are women who are traditionally tasked with managing their homes, increasing workload at the workplace affects their family duties and health. Significantly, being tied to and tired at the workplace means female health practitioners’ inability to support their homes the way they ought to. A recent study by Rajan argues that increasing workload results in tiredness in the work place, weight loss, stress, irritation and general body pains (Rajan, 2018Rajan, D. (2018) “Negative Impacts of Heavy Workload: A Comparative Study among Sanitary Workers.” Sociology International Journal, 2 (6), pp. 465-474. doi: 10.15406/sij.2018.02.00086 ).

Lack of Logistics needed to work

Aside understaffing, previous studies have addressed the question of inadequate logistics as a major detriment to proper health delivery in Africa (Manso, Annan and Anane, 2013Manso, J. F., Annan, J. and Anane, S. S. (2013) “Assessment of Logistics Management in Ghana Health Service.” International Journal of Business and Social Research, 3 (8), pp. 75-87. doi: https://doi.org/10.18533/ijbsr.v3i8.267 ; Jahre et al., 2012Jahre, M., Dumoulin, L., Greenhalgh, L. B., Hudspeth, C., Limlim, P., and Spindler, A. (2012) “Improving Health in Developing Countries: Reducing Complexity of Drug Supply Chains.” Journal of Humanitarian Logistics and Supply Chain Management, 2 (1), pp. 54-58. doi: https://doi.org/10.1108/20426741211226000 ; Apanga and Awoonor-Williams, 2018Apanga, P. A., and Awoonor-William, J. K. (2018) “Maternal Death in Rural Ghana: A Case Study in the Upper East Region of Ghana.” Front Public Health, 6 (101), pp. 1-6. doi: https://doi.org/10.3389/fpubh.2018.00101 ). In Ghana, the literature argues that there are inadequate facilities coupled with limited drugs that are required to treat patients (Manso, Annan and Anane, 2013Manso, J. F., Annan, J. and Anane, S. S. (2013) “Assessment of Logistics Management in Ghana Health Service.” International Journal of Business and Social Research, 3 (8), pp. 75-87. doi: https://doi.org/10.18533/ijbsr.v3i8.267 ). Similarly, Apanga and Awoonor-Williams (2018)Apanga, P. A., and Awoonor-William, J. K. (2018) “Maternal Death in Rural Ghana: A Case Study in the Upper East Region of Ghana.” Front Public Health, 6 (101), pp. 1-6. doi: https://doi.org/10.3389/fpubh.2018.00101 have postulated that the healthcare delivery system in Ghana is weak due to the fact that there are no available basic logistics including medical and laboratory equipment. Our findings confirm that limited logistics and facilities tend to be a challenge to proper healthcare delivery. A midwife in one of the hospitals hinted:

Inadequate logistics result in the loss of lives of the patients of women health practitioners. Significantly, when the above persists, it hinders the efforts of women health practitioners from reaching their sustainable development goals, especially aspects that focus on maternal and infant health.

On several occasions, serious and severe cases reported at the hospital becomes challenging due to inadequate logistics. In cognizance with the above, the Ministry of Health (MoH) have implemented a policy that seeks to transfer patients from primary care levels to other appropriate centers for continuous care (MoH, 2012Ministry of Health (MoH). (2012) Ministry of Health: Referral Policy and Guidelines. Available at: https://www.moh.gov.gh/wp-content/uploads/2016/03/Referral-Policy-Guidelines.pdf [Accessed 5 Jun. 2020].). This policy allows patients to be referred to relatively larger hospitals around the town (MoH, 2012Ministry of Health (MoH). (2012) Ministry of Health: Referral Policy and Guidelines. Available at: https://www.moh.gov.gh/wp-content/uploads/2016/03/Referral-Policy-Guidelines.pdf [Accessed 5 Jun. 2020].). However, there is the challenge of access and proximity. In the case of Obuasi, patients in critical conditions are referred to “larger hospitals with adequate facilities like the Komfo Anokye Teaching Hospital in Kumasi” (Dr. Agnes, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ). Referrals can be threatening to the health and well-being of expectant mothers and the unborn baby including patients in general, considering the distance from the health centers to the referred hospitals in Kumasi. An interviewee also claimed that travelling to the referred hospitals also tend to be a major problem due to the fact that vehicles as well as ambulances needed for such purposes are not available in the hospitals. On several occasions, patients have to be transported via the normal passenger cars.

Non-Compliance by patients

The relationship between health workers and their clients has not always been successful as most of the patients display high level of non-compliance toward their care givers (Russell et al., 2003Russell, S., Daly, J., Hughes, E. and Hoog-co, C. (2003) “Nurses and ‘Difficult’ Patients: Negotiating Non-compliance.” Journal of Advanced Nursing, 43 (3), pp. 281-287. doi: https://doi.org/10.1046/j.1365-2648.2003.02711.x ; Kleinsinger, 2010Kleinsinger, F. (2010) “Working with the Noncompliant Patient.” The Permanente Journal, 14 (1), pp. 54-60. doi: https://doi.org/10.7812/tpp/09-064 ; Naghavi et al., 2019Naghavi, S., Mehrolhassani, M. H., Nakhaee, N. and Yazdi-Feyzabadi, V. (2019) “Effective Factors in Non-compliance with Therapeutic Orders of Specialists in Outpatient Clinics in Iran: A Qualitative Study.” BMC Health Service Research, 19, pp. 413-428. doi: https://doi.org/10.1186/s12913-019-4229-4 ). Our finding on non-compliant behavior has revealed that it becomes very challenging for health workers to fully discharge their responsibilities as most patients tend to break the chain of success by not adhering to the suggestion of health workers. Significantly, the nurses, midwives and physicians included in the study hinted that lack of cooperation by patients and their family members is one of the pressing challenges they face. The literature on patients’ non-compliance mostly focus on medication non-adherence (Sharif, Ogunbanjo and Malete, 2003Sharif, S. A., Ogunbanjo, G. A. and Malete, N. H. (2003) “Reasons for Non-compliance to Treatment among Patients with Psychiatric Illness: A Qualitative Study.” South African Family Practice, 45 (4), pp. 10-13.; Lauffernburger et al., 2019Lauffenburger, J. C., Khan, N. F., Brill, G. and Choudhry, N. K. (2019) “Quantifying Social Reinforcement among Family Members on Adherence to Medications for Chronic Conditions: A US-based Retrospective Cohort Study.” Journal of General Internal Medicine, 34 (6), pp. 855-861. doi: https://doi.org/10.1007/s11606-018-4654-9 ; Trivedi and Asch, 2019Trivedi, R. and Asch, S. M. (2019) “Can We Improve Patient Adherence by Harnessing Social Forces?” Journal of General Internal Medicine, 34, pp. 785-786. doi: https://doi.org/10.1007/s11606-019-04856-4 ). A study in the United States of America for example, argues that almost half of the patients with chronic diseases report medication non-adherence (Lauffernburger et al., 2019Lauffenburger, J. C., Khan, N. F., Brill, G. and Choudhry, N. K. (2019) “Quantifying Social Reinforcement among Family Members on Adherence to Medications for Chronic Conditions: A US-based Retrospective Cohort Study.” Journal of General Internal Medicine, 34 (6), pp. 855-861. doi: https://doi.org/10.1007/s11606-018-4654-9 ). In addition to the above, we discuss a workplace non-adherence arising from the impatience of patients. A nurse hinted:

Our finding has revealed that, though patients are discharged upon recovery, there has been several instances where most discharged patients returned to the hospital with serious complications of same diseases that were treated. As reported in the literature, this results from non-adherence on the part of patients concerning their medication (Sharif, Ogunbanjo and Malete, 2003Sharif, S. A., Ogunbanjo, G. A. and Malete, N. H. (2003) “Reasons for Non-compliance to Treatment among Patients with Psychiatric Illness: A Qualitative Study.” South African Family Practice, 45 (4), pp. 10-13.; Lauffernburger et al., 2019Lauffenburger, J. C., Khan, N. F., Brill, G. and Choudhry, N. K. (2019) “Quantifying Social Reinforcement among Family Members on Adherence to Medications for Chronic Conditions: A US-based Retrospective Cohort Study.” Journal of General Internal Medicine, 34 (6), pp. 855-861. doi: https://doi.org/10.1007/s11606-018-4654-9 ; Trivedi and Asch, 2019Trivedi, R. and Asch, S. M. (2019) “Can We Improve Patient Adherence by Harnessing Social Forces?” Journal of General Internal Medicine, 34, pp. 785-786. doi: https://doi.org/10.1007/s11606-019-04856-4 ). This notwithstanding, our current discourse argues that in addition to failure to follow medication protocols, some patients are also impatient and can even go to the extent of abusing health workers whiles the latter discharge the responsibilities towards relieving the former of their condition. In Obuasi, guiding, directing and supporting patients and clients to be in good shape in the “wait-queues” of health centers have been a role played by nurses, and women nurses in particular.

Longer Working Hours

Within the Obuasi community, women in the biomedical sphere revealed that their work is time consuming. Discourses on long working hours report that the act can be detrimental to one’s health (Tucker and Folkard, 2012Tucker, P. T. and Folkard, S. (2012) Working Time, Health and Safety: A Research Synthesis Paper. Geneva: International Labour Office, Series No. 31.; Bernstrøm et al., 2019Bernstrøm, V. H., Alves, D. E., Ellingsen, D. and Ingelsrud, M. H. (2019) “Healthy Working Time Arrangements for Healthcare Personnel and Patients: A Systematic Literature Review.” BMC Health Service Research, 19 (193). doi: https://doi.org/10.1186/s12913-019-3993-5 ; Berniell, 2012Berniell, M. I. (2012) “The Effects of Working Hours on Health Status and Health Behaviors.” 15th IZA European Summer School in Labor Economics. Available at http://conference.iza.org/conference_files/SUMS2012/berniell_m7629.pdf ; Rogers et al., 2004Rogers, A. E., Hwang, W., Scott, L. D., Aiken, L. H. and Dinges, D. F. (2004) “The Working Hours of Hospital Staff Nurses and Patient Safety.” Health Affairs, 23 (4), pp. 202-212. doi: https://doi.org/10.1377/hlthaff.23.4.202 ). Tucker and Folkard (2012)Tucker, P. T. and Folkard, S. (2012) Working Time, Health and Safety: A Research Synthesis Paper. Geneva: International Labour Office, Series No. 31. argue that long working schedules can result in stress, fatigue, derail physical health, social and family disruption among others.

As already described above, due to the shortage of health workers in the health centers of the Obuasi community, there is an increase in work load which results in spending much time in health facilities or hospitals. On a different level, spending longer hours at the work place also affect the time health workers spend with their families. A nurse hinted that:

It can be argued that work schedule has a direct relationship with the time one spends with her family. From the interviews conducted, it can be established that long working hours limit the time women health workers spend with their families and vice versa. According to Manuh (1991)Manuh, T. (1991) “Women and their Organizations During the Convention People’s Party.” In: K. Arhin, ed., Life and Work of Kwame Nkrumah: Papers of a Symposium. Accra, New Jerssey: Sedco/Africa World Press, pp. 101-127., women are specifically tasked with holding their household units and families together. Once women in the biomedical sector spend more time at work, their role of “holding the household units together” is challenged. To that extent, spending long hours at work results in family conflict, especially between the women in the biomedical centers and their husbands. Significantly, a nurse reported that, it is as a result of the fear of entering into conflicts with her spouse that she is still single (Mary, interview, 2019Interviews, Obuasi, 2019: A. Elizabeth, Dr. N. Agnes, E. Ofosu, F. Mercy, H. Rahamat, K. Afia, K. Lucy, M. Nyamekye, N. Doris, O. K. Poku, O. Mary, O. Regina, P. Diana, P. Osei, S. Mavis and Y. Mansa. ).

Concerning working for longer hours, a respondent hinted:

We infer from the above that in Obuasi, health workers are likely to work more than twelve hours a day. As already established in the literature, our respondents also reported that working for long hours affect their health. Significantly, aside having an impact on the health worker in question, long duration at the work place also has the proclivity to affect their efficiency at the hospital, especially caring and supporting their patients. In support of this assertion, a research by Rogers and his peers revealed that the risks of healthcare error increases when healthcare workers exceeded twelve hours a day and more than forty hours per week (Rogers et al., 2004Rogers, A. E., Hwang, W., Scott, L. D., Aiken, L. H. and Dinges, D. F. (2004) “The Working Hours of Hospital Staff Nurses and Patient Safety.” Health Affairs, 23 (4), pp. 202-212. doi: https://doi.org/10.1377/hlthaff.23.4.202 ).