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

Abstract

BackgroundThe International Safe Motherhood initiative provides a focus for programmes and research to improve maternal health in low – income countries. Antenatal care is one of the key pillars of the initiative. This study sought to examine the association between background characteristics and choice of skilled providers of antenatal care services in Ghana.MethodsThe study used data from the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to analyse the data.ResultsResults show that the proportion of women who received antenatal care (ANC) services from skilled providers improved over the period. Also, women with secondary education (OR = 1.42, CI = 1.07–1.88), richest wealth status (OR = 5.10, CI = 2.28–11.85) were more likely to utilise antenatal care services from skilled providers. Whereas women from rural areas (OR = 0.55, CI = 0.41–0.74), with four births or more (OR = 0.55, CI = 0.36–0.85) and from the northern ethnic group were less likely to utilise antenatal care services from skilled providers.ConclusionChoice of skilled providers of antenatal care services were predicted by some predisposing factors including education, ethnicity, and ecological zone. Also enabling factors such as wealth status, residence and the need for care factor, parity predicted choice of skilled providers of antenatal care services. Women with secondary or higher education, those within richer and richest wealth status, those from forest zone are more likely to utilise the services of skilled providers during their antenatal care visits. Whereas women from rural areas, those with four births or more and those with the northern ethnic group were more likely to utilise ANC service from unskilled providers. The Ghana Health Service and Ministry of Health should encourage women in rural areas to utilise antenatal care services from skilled providers through social and behaviour change communication campaigns.

Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania

“…The present study showed that women who attained at least primary education were more likely to attend between one and three ANC visits, and this association was even stronger for those who made four or more ANC visits. This finding is similar to studies conducted in Ethiopia [34], Ghana [62,63], Timor-Leste [64] and Kenya [65], which found that higher maternal education was associated with increased uptake of ANC services. Probable reasons for why educated women have increased ANC use might be that educated women have the potential to engage more with health promotion messages or they may have better insights into the benefits of attending ANC [62].…”

“…This finding is similar to studies conducted in Ethiopia [34], Ghana [62,63], Timor-Leste [64] and Kenya [65], which found that higher maternal education was associated with increased uptake of ANC services. Probable reasons for why educated women have increased ANC use might be that educated women have the potential to engage more with health promotion messages or they may have better insights into the benefits of attending ANC [62]. Educated women are also likely to have the financial resources to pay for direct and indirect costs related to ANC services in a country like Tanzania, where health services are largely provided through out-of-pocket costs [66].…”

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

“…The findings indicate that only 15.3% of women made their first ANC visit within the first trimester, three-fifth had adequate ANC visits and three-quarter took HIV test during pregnancy. The prevalence of early ANC visits is lower than that of Ghana where 88% of the sample women received ANC care in 2014 [23]. In a multicountry study based on demographic and Health Survey data, Ghada et al reported that the prevalence of having adequate ANC visits were Cameroon (62.7%), Senegal (51.2%), Uganda (48.5) [24].…”

Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

“…Although previous studies have established the value of FANC [6,9,12,13], only a few make reference to the primary healthcare context in which FANC has operated. Dickson, Darteh, and Kumi-Kyereme [27] suggested that increased utilization and improved access to ANC could be attributed to the Community-Based Health Planning and Services (CHPS). Also, Naariyong et al [28] made similar assertions when they indicated that 'pregnant women benefitted from better technical process quality of ANC services under the CHPS initiative than that found in non-CHPS areas in Ghana, expressly because of the design of the CHPS intervention' .…”