The influence of distance and quality of care on place of delivery in rural Ghana

Nesbitt, Robin; Lohela, Terhi J.; Soremekun, Seyi; Vesel, Linda; Manu, Alexander; Okyere, Eunice; Grundy, Chris; Amenga‐Etego, Seeba; Owusu‐Agyei, Seth; Kirkwood, Betty; Gabrysch, Sabine

doi:10.1038/srep30291

Cited by 59 publications

(70 citation statements)

References 24 publications

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“…Results consistent with our study were reported by Kumari et al and others. 19,30,31 Our study observed no statistically significant association between place of delivery and factors like age of mother at delivery, religion and socio-economic status of the women. These findings were consistent with that of study performed by Pandey et al 20 In the multiple regression analysis of the 8 factors, only 3 factors were found to be independently significant, namely, Education of women, Occupation of husband and education of husband.…”

Section: Discussioncontrasting

confidence: 51%

Study to access the socio-demographic determinants and the reasons for preference of place of delivery in rural women of Paithan, Aurangabad (Maharashtra)

Kuril

Pund

Doibale

et al. 2017

Int J Community Med Public Health

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Background: Maternal health reflects the overall effectiveness of the health system of any country. One strategy for reducing maternal mortality and morbidity is ensuring that every baby is delivered in an institution. Government of India has launched various health schemes under the umbrella of National Rural Health Mission (NRHM) to promote institutional deliveries. Thus this study was conducted to study the socio-demographic determinants of place of delivery and the reasons for preference of place of delivery by rural women.Methods: A community based cross-sectional study was conducted in the field practice area of rural health training center (RHTC), Paithan, Dist. Aurangabad during the period of 1st October 2015 to 31st March 2016. All the villages under two sub-centers of one PHC under the RHTC were selected for the study. All women above 18 years of age who delivered at least once between 1st January 2001 to 31st December 2015, were interviewed for their place of delivery and their socio-demographic profile.Results: It was observed that 564 (80.46%) women were delivered in a hospital, of which 313 (44.65%) and 251 (35.81) were delivered in private and government institutions respectively, while 137 (19.54%) respondent women were delivered at home. Education of women, occupation of women, type of Family, education of husband, occupation of husband, parity, distance of hospital from the residence and women’s age at marriage were the socio-demographic factors found to be significantly associated with place of delivery by the bivariate analysis. Reasons observed for home delivery were related to lack of knowledge about government healthcare facilities, about need for institutional delivery and inability to reach hospital on time.Conclusions: The proportion of home deliveries in 2001-15 was 13.08% as against 35.80% of government institutional deliveries and 44.65% of private institutional deliveries. Education of women, education and occupation of husband were found to be significantly associated with place of delivery by multivariate analysis.

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Section: Discussioncontrasting

confidence: 51%

Study to access the socio-demographic determinants and the reasons for preference of place of delivery in rural women of Paithan, Aurangabad (Maharashtra)

Kuril

Pund

Doibale

et al. 2017

Int J Community Med Public Health

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“…Few studies have assessed the influence of both distance and the quality of healthcare on the way skilled childbirth attendance services are used in low and middle-income countries 11 12. These studies have used data from specific research projects such as clinical trials11 or Demographic and Health Surveys (DHS),13 14 rather than being based on routinely collected health management information systems (HMIS) data. Studies using the DHS have examined attendance at any health facility by distance to the nearest facility, but have not examined attendance at specific, named facilities nor the impact of quality of maternal care services provided on health facility use 15.…”

Section: Introductionmentioning

confidence: 99%

The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana

et al. 2020

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ObjectivesSkilled birth attendance is the single most important intervention to reduce maternal mortality. However, studies have not used routinely collected health service birth data at named health facilities to understand the influence of distance and quality of care on childbirth service utilisation. Thus, this paper aims to quantify the influence of distance and quality of healthcare on utilisation of birthing services using routine health data in Eastern Region, Ghana.MethodsWe used a spatial interaction model (a model that predicts movement from one place to another) drawing on routine birth data, emergency obstetric care surveys, gridded estimates of number of pregnancies and health facility location. We compared travel distances by sociodemographic characteristics and mapped movement patterns.ResultsA kilometre increase in distance significantly reduced the prevalence rate of the number of women giving birth in health facilities by 6.7%. Although quality care increased the number of women giving birth in health facilities, its association was insignificant. Women travelled further than expected to give birth at facilities, on average journeying 4.7 km beyond the nearest facility with a recorded birth. Women in rural areas travelled 4 km more than urban women to reach a hospital. We also observed that 56% of women bypassed the nearest hospital to their community.ConclusionThis analysis provides substantial opportunities for health planners and managers to understand further patterns of skilled birth service utilisation, and demonstrates the value of routine health data. Also, it provides evidence-based information for improving maternal health service provision by targeting specific communities and health facilities.

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“…This also may be a result of women being referred to the higher‐level facilities that offer comprehensive services. Nesbitt et al . found that a clinic's care capacity and quality did not influence the rates of facility use except if that facility provided substandard EMONC.…”

Section: Discussionmentioning

confidence: 99%

Understanding the gap in emergency obstetric and neonatal care in Ghana through the PREventing Maternal And Neonatal Deaths (PREMAND) study

Kaselitz

James

Aborigo

et al. 2019

Intl J Gynecology & Obste

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Objective To explore basic and comprehensive emergency obstetric service provision across four districts in rural northern Ghana, and whether women were more likely to deliver at facilities with more skilled care. Methods Field workers geo‐coded all health facilities in East Mamprusi, Sissala East, Kassena Nankana Municipal, and Kassena Nankana West districts, and administered surveys to assess providers and emergency obstetric care available. Data were also prospectively collected on delivery locations of women and neonates who died, or nearly died (near misses), between September 1, 2015 and April 30, 2017. Results There were 14 physicians for a population of nearly 360 000 women. Six (6%) facilities could provide basic emergency care, and 3 (3%) could provide comprehensive care. Services were distributed unequally, with 6 (67%) of the emergency facilities located in the least populated district. Among the sample of women and neonates who died or nearly died, 175 (39%) delivered at locations unable to provide basic emergency services. Conclusion Access to emergency obstetric and neonatal care was distributed inequitably across these districts, suggesting the need to revisit geographic placement of facilities relative to population. The study also raised the question of how to ensure facilities are equipped to respond to emergencies.

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The influence of distance and quality of care on place of delivery in rural Ghana

Cited by 59 publications

References 24 publications

Study to access the socio-demographic determinants and the reasons for preference of place of delivery in rural women of Paithan, Aurangabad (Maharashtra)

Study to access the socio-demographic determinants and the reasons for preference of place of delivery in rural women of Paithan, Aurangabad (Maharashtra)

The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana

Understanding the gap in emergency obstetric and neonatal care in Ghana through the PREventing Maternal And Neonatal Deaths (PREMAND) study

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