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

Kwamena Sekyi Dickson,Akwasi Kumi-Kyereme,Eugene Kofuor Maafo Darteh,Bright Opoku Ahinkorah

doi:10.1186/s40748-018-0082-4

Kwamena Sekyi Dickson, Akwasi Kumi-Kyereme + Show 2 more

Open Access

https://doi.org/10.1186/s40748-018-0082-4

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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.

Highlights

The International Safe Motherhood initiative provides a focus for programmes and research to improve maternal health in low – income countries
Using the health care service utilisation model, the current study examines the factors that influence antenatal care services utilisation from skilled providers in Ghana over the period from 1988 to 2014
The results suggest that women from the forest zone (OR = 2.78, Confidence Interval (CI) = 2.02–3.83) were more likely to use the ANC services from skilled providers during antenatal care services as compared to those from the coastal zone

Summary

Introduction

The International Safe Motherhood initiative provides a focus for programmes and research to improve maternal health in low – income countries. The health of women during pregnancy became an immense concern in the early 1980s due to the high maternal mortality ratios [7] This is because the care given to women during pregnancy provides interventions that enhance maternal health and survival during the period immediately before and after childbirth [8]. This led to the commencement of the safe motherhood programme. The International Safe Motherhood initiation was launched in Nairobi, Kenya in 1987 and provided a focus for programmes and research concerned with the improvement of maternal health in low – income countries. Antenatal care was one of the key pillars of the safe motherhood [7]

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