Abstract
Improving maternal health is a global public health challenge especially in sub-Saharan Africa. The optimum utilisation of antenatal care (ANC) by pregnant women is known to improve maternal health outcomes. Maternal morbidity and mortality rates in Ghana remain unacceptably high, particularly in rural settings where skilled delivery care often times is disproportionally low. This study assessed factors associated with optimum utilisation of antenatal care in rural Ghana. A cross-sectional design was applied to collect data among eligible participants between October 2018 and January 2019. A total of 322 women who gave birth and attended the postnatal clinic were recruited for the study. Consecutive sampling was employed in recruiting participants. The associations between the dependent variables (ANC service utilisation and knowledge of ANC) and independent variables (socio-demographic characteristics) were examined using ordinary least squares logistic regression at 95% confidence interval in STATA version 14.0. Of the 322 participants, 69.0% reported utilising at least four or more times ANC services. Determinants of women attending ANC for four or more times was significantly associated with age [OR = 4.36 (95%CI: 2.16-8.80), p<0.001], educational level [OR = 10.18 (95%CI: 3.86-26.87), p<0.001], and insured with National Health Insurance Scheme [OR = 3.42 (95%CI: 1.72-6.82), p<0.001]. Not married [OR = 0.65 (0.39-1.09), p = 0.011] or divorced [OR = 0.33 (95%CI: 0.13-0.83), p = 0.019] was negatively associated with utilisation of four or more ANC services. The majority (79.0%) of the participants had a good level of knowledge regarding antenatal care. Although the majority of women in this study had good knowledge of ANC services, a significant number of them did not complete the recommended number of ANC visits for at least four times during a normal pregnancy. Awareness and further education to reproductive-age women on the significant role adequate ANC attendance plays in advancing health and well-being require further investments, particularly among rural women in Ghana.
Highlights
Improving maternal health is a global public health challenge especially in sub-Saharan Africa
About 303, 000 women and adolescent girls die as a result of pregnancy and childbirth-related complications [1] of which an alarming 99% of these maternal deaths occur in low-resource settings
The number of women and girls dying due to pregnancy-related complications and childbirth decreased by nearly half (50%) from 1990 to 2013, the number of deaths within the West African region remains unacceptably high with Maternal Mortality Ratio (MMR) of 679 deaths per 100,000 live births in 2015 [2,3,4]
Summary
A cross-sectional design was applied to collect data among eligible participants between October 2018 and January 2019. The study applied a cross-sectional analytical facility-based study design to recruit the study participants. Quantitative data was collected among eligible study participants after applying the appropriate sampling methodology. This design was appropriate to enable the study team to elicit answers to key questions that underpin the study. The study was conducted at four health facilities in Bamboi, a sub-district jurisdiction under the Bole district in the Savanah region of Ghana. The district health services are divided into four sub-districts namely Bole, Tinga, Jama, and Bamboi. The eligible study population were all reproductive-aged women in the Bambi sub-district who attended the study health facilities in Bamboi sub-district for postnatal care during the time of the study
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