Abstract
BackgroundHome births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana.MethodsData for this study was obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. For the purpose of this study, a sample size of 2,101 women in the rural areas who had given birth within five years prior to the survey and had responses on variables was considered. Data processing, management and analysis were carried out using STATA version 14.0. This study carried out bivariate and multivariate analyses and results were tested at 95% confidence interval. The Adjusted odds ratios were used to present the results and the level of statistical significance was assessed using 95% confidence intervals.ResultsHome births was found to be high among women who resided in the Northern region compared to those in the Western region [AOR, 1.81 CI = 1.10–2.98]. Similarly, the likelihood of home birth was high among women with four or more births [AOR, 1.46 CI = 1.03–2.05] and Traditionalists [AOR, 2.50 CI = 1.54–4.06]. Conversely, giving birth at home was low among women with higher level of education [AOR = 0.58, CI = 0.43–0.78], those with rich wealth status [AOR = 0.19, CI = 0.10–0.38], those with four or more ANC visits [AOR = 0.11, CI = 0.15–0.23] and those who were covered by NHIS [AOR = 0.58, CI = 0.46–0.72].ConclusionsOver the years, there have been efforts by governments in Ghana to make maternal health services free in the country. However, a substantial proportion of women still undergo home births. To reduce the utilization of home births in Ghana, it is essential that government and non-governmental organisations make the cost of delivery services part of the free maternal health care policy and take into consideration the factors associated with the high rates of home births among rural women in Ghana.
Highlights
Home births is one of the factors associated with maternal mortality
The results show that home births were high among women aged 25–34(47.4%), those in the Northern region (32.2%), non-working women (86.0%), those of the Mole Dagbani Ethnic group (28.0%), those with poor wealth status (86.7%), those with parity four or more (60.5%), Christians (63.0%) and those with no education (58.6%)
Home births were high among women with male household heads (87.8%), those who had four or more ANC visits (69.8%), those who did not take healthcare decisions alone (84.2%), those who neither read newspaper/magazine (97.7%) nor watched television (63.0%), those who listened to radio at least once a week (38.3%) and those who were covered by NHIS (59.9%)
Summary
Home births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana. In low- and middle-income countries (LMICs), there is high tendency for women in rural areas to give birth at places outside a healthcare facility, where there is no to minimal skilled obstetric care [3, 4] Most of such births are not done by skilled birth attendants (SBAs) such as doctors, physician assistants, midwives or nurses but rather by traditional birth attendants (TBA), relatives and friends [5]. In sub-Saharan Africa, hemorrhage, hypertension, sepsis and obstructed labour that emerge around the time of labour and delivery are the major causes of maternal deaths [7] To reduce this risk, one of the most effective intervention was the universal skilled birth attendance which in SSA is often equated with facility-based births [6]. Lack of skilled birth attendance is a major drawback to achieving SDG 3 target 3.1, which aims at reducing global maternal mortality ratio to less than 70 per 100,000 [11]
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