What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

Abstract

Background In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Materials and methods Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses. Results We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17–0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06–3.86], women who professed other religions [AOR = 3.45; CI = 1.53–7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64–31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17–0.53], compared to those with no formal education. Conclusion The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so.

Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

“…In compared with women with poorest wealth status, the odds of home delivery were decreased by 26%, 40%, 55% and 73% among women with poorer, middle, richer and richest wealth status, respectively. This result was in agreement with the previous studies [26][27][28]31]. Financial capability of families and costs related to transportation may determine the place of delivery.…”

“…Women living rural area had as higher odds of home delivery, which is similar to ndings in previous studies [23,28,31,37]. Rural residents in Sub Saharan countries have poor access to health care facilities.…”

“…Educated women had less likelihood of home deliver as compared to uneducated women. The result was in line with the individual studies conducted in rural Ethiopia [26][27][28], Zimbabwe [29], Nigeria [30], Ghana [31,32], Guinea [23] and Nepal [33]. The reason for this might be due the fact that when mothers are educated it is more is likely to enhance female self-determination, positive attitude, and nancial freedom [34,35].…”

Prevalence, progress, and social inequalities of home deliveries in Ghana from 2006 to 2018: insights from the multiple indicator cluster surveys

“…Home delivery refers to the practice of childbirth that occurs at the place of residence of the pregnant woman or the homes of other people [5,6]. These births are attended by unskilled personnel including traditional birth attendants (TBAs), relatives, and friends as substitutes for skilled birth attendants [5,7]. A skilled birth attendant is "an accredited health professional -such as a midwife, doctor or nurse -who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth, and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns" [8].…”

“…These initiatives contributed significantly to reducing home delivery from 45% in 2007 to 20% in 2017 [ 18 ]. Despite the significant concerted global and national efforts, uptake of IBD remains low, with many childbearing women continuing to deliver their babies at home due to limited access to maternal healthcare services including delivery services [ 7 , 19 , 20 ]. Hence, there is a need to estimate the prevalence and explore the nuances associated with home delivery.…”