Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988–2014

Abstract

BackgroundAntenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 – achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014.MethodsThe study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services.ResultsThe results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses.ConclusionTo further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient’s satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour change communication campaigns.

Determinants of choice of skilled antenatal care service providers in Ghana: analysis of demographic and health survey

“…The study observed that women with secondary or higher education are more likely to receive antenatal care services from skilled providers compared with those with no education. This finding is consistent with findings of other studies [ 17 , 19 , 33 – 35 ]. The possible explanation for the findings is that women with secondary or higher education may have more awareness about the danger signs and complications of pregnancy and may know the need to receive ANC services from a skilled provider.…”

“…Furthermore, women from rural areas were less likely to utilise the services of skilled providers. This is consistent with the findings by Dickson, Darteh and Kumi-Kyereme [ 17 ], who also found that women in rural areas were less likely to receive ANC services from doctors and nurses compared to those in urban areas. One reason for the findings could be the urban-rural gap in the distribution of health resources, where those in urban areas are more likely to have access to tertiary health centres compared to those in rural areas.…”

“…In regions where the rates of maternal mortality are high, such as sub–Saharan Africa even fewer women obtain at least four antenatal visits from skilled providers - 49% which is less than the global average [ 16 ]. There is also evidence that some pregnant women do not utilise antenatal care services from any provider [ 17 – 22 ]. What factors influence pregnant women to utilise antenatal care from skilled providers?…”

Determinants of Skilled Birth Attendance in the Northern Parts of Ghana

“…The fact that partner's education predicted delivery even better than the women's own education level points to the significant mediating roles men play in women's health decision-making. This finding is in agreement with studies on influences of partners' characteristics on women's health previous decision-making [35][36][37]. The implication of this finding is that utilization of skilled delivery services may continue to be low in the Northern parts of the country if male partner involvement is not promoted in the country.…”

Understanding the endorsement of wife beating in Ghana: evidence of the 2014 Ghana demographic and health survey

“…The results showed that few women (6.3%) and men (11.8%) had attained higher education. As noted in the 2010 Population and Housing Census that Christianity is the leading religion in Ghana [26,27], the study found that most women (80.1%) and men (72.5%) were Christians.…”