Abstract
BackgroundThis study investigates factors determining the timing of antenatal care (ANC) visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women.MethodData for the study was drawn from the women questionnaire (N=4,916) of the 2008 Ghana Demographic and Health Survey among 15–49-years-old women. Multivariate logistic regression analysis was used to explore factors determining the type of delivery assistance and timing of ANC visit for live births within five years prior to the survey.ResultsMajority of Ghanaian women attended ANC visit (96.5%) but many (42.7%) did so late (after the first trimester), while 36.5% had delivery without the assistance of a trained personnel (30.6%) or anyone (5.9%). Age (OR=1.5, CI=1.1-1.9, OR for 25-34-year-olds compared to 15-24-year-olds), religion (OR=1.8, CI=1.2-2.8, OR for Christians versus Traditional believers) wealth index (OR=2.6, CI=1.7-3.8, OR for the richest compared to the poorest) were independently associated with early ANC visit. Likewise, age, place of residence, education and partner’s education were associated with having a delivery assisted by a trained assistant. Also, Christians (OR=1.8, CI=1.1-3.0) and Moslems (OR=1.9, CI=1.1-3.3) were more likely to have trained delivery assistants compared to their counterparts who practised traditional belief. Furthermore, the richer a woman the more likely that she would have delivery assisted by a trained personnel (OR=8.2, CI= 4.2-16.0, OR for the richest in comparison to the poorest).ConclusionsDespite the relatively high antenatal care utilisation among Ghanaian women, significant variations exist across the socio-demographic spectrum. Furthermore, a large number of women failed to meet the WHO recommendation to attend antenatal care within the first trimester of pregnancy. These findings have important implications for reducing maternal mortality ratio by three-quarters by the year 2015.
Highlights
This study investigates factors determining the timing of antenatal care (ANC) visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women
Factors associated with early antenatal care visit The following socio-demographic factors were associated with early ANC visit bivariately; age, place of residence, parity, education, religion, wealth index and partner’s education (Table 2, Model 1)
In multivariate analyses after controlling for each of these socio-demographic factors that were statistically significant at the bivariate level (Table 2, Model 2), age (OR=1.5, confidence intervals (CI)=1.2-1.9, odds ratios (OR) for 25–34 year olds compared to 15–24 year olds), religion (OR=1.8, CI=1.22.7, OR for Christians versus Traditional believers) and wealth index (OR=3.4, CI=2.2-5.2, OR for the richest compared to the poorest) increased the likelihood of having early ANC visit
Summary
This study investigates factors determining the timing of antenatal care (ANC) visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women. The fifth Millennium Development Goal (MDG) of United Nations (UN) is to improve maternal health and this is to be achieved by reducing maternal mortality ratio by three-quarters between 1990 and 2015 [7]. On the other hand, preventing maternal mortality and morbidity to ensure that women receive appropriate care during delivery still remained one of the critical issues. One of the reports of United Nations Children's Fund (UNICEF) shows that, 4 in 10 of all births worldwide are not assisted by skilled health personnel [9]. 99 per cent of deliveries in developed countries are assisted by skilled personnel
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