Quality of Antenatal Care Services in the Birim North District of Ghana: Contribution of the Community-Based Health Planning and Services Program

Abstract

To compare the quality of antenatal care (ANC) between Community-based Health Planning and Services (CHPS) and non-CHPS areas in the Birim North District of Ghana. A cross-sectional study was conducted in May, 2010. We collected data from 600 women (300 from CHPS areas and 300 from non-CHPS areas) recruited from six CHPS and six non-CHPS areas, using a structured questionnaire. Participants were aged 15-49years, had at least one child within 18months old, and resided in the district for at least 2years before data collection. Outcomes included: (1) index of ANC utilization (dichotomized as full and partial), (2) receipt of anti-malarial drugs, (3) testing for HIV infection, and (4) index of knowledge about pregnancy danger signs (expressed in tertiles). Descriptive statistics and multivariate logistic regression methods were employed in the analysis. Multivariate analysis revealed that participants in the CHPS areas were 2.7 times (95% CI: 1.66-4.35) more likely to have full utilization score, 4.5 times (95% CI: 2.37-8.51) more likely to receive HIV testing, and 3.7 times (95% CI: 1.72-7.94) more likely to receive anti-malarial prophylaxis during the ANC period. However, scoring high on the index of knowledge was not significantly associated with the CHPS exposure (OR: 1.2; 95% CI: 0.69-2.00). The CHPS intervention might be useful to improve the quality of ANC. Therefore, increasing the CHPS intervention coverage in non-CHPS areas might serve as a basis for improving the quality of ANC in the Birim North and other rural districts of Ghana.