Focused maternity care in Ghana: results of a cluster analysisReport as inadecuate

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BMC Health Services Research

, 16:395

Health systems and services in low and middle income settings


BackgroundGhana missed out in attaining Millennium Development Goal 5 in 2015. The provision of adequate prenatal and postnatal care remains problematic, with poor evidence on women’s views on met and unmet maternity care needs across all regions in Ghana. This paper examines maternal care utilization in Ghana by applying WHO indicators for focused maternal care utilization.

MethodsTwo-step cluster analysis segregated women into groups based on the components of the maternity care used. Using cluster membership variables as dependent variables, we applied multinomial and binary regression to examine associations of care use with individual, household and regional characteristics.

ResultsWe identified three patterns of care use: adequate, less and least adquate care. The presence of a female and skilled provider is an indicator of adequate care. Women in Volta, Upper West, Northern and Western regions received less adequate care compared with other regions. Supply-related factors drugs availability, distance-transport, health insurance ownership, rural residence were associated with adequacy of care. The lack of female autonomy, widowed-divorced women, age and parity were associated with less adequate care. Care patterns were distinctively associated with the quality of health care support skilled and female attendant instead of with the number of visits made to the facility. Across regions and within rural settings, disparities exist, often compounded by supply-related factors.

ConclusionsEfforts to address skilled workforce shortages, greater accountability for quality and equity, improving women motivation for care seeking and active participation are important for maternity care in Ghana.

KeywordsDelivery care Facility utilisation Medication care Prenatal care Postnatal care Skilled delivery WHO delivery care components Ghana AbbreviationsANCAntenatal care

CHOCommunity health officer

CHPSCommunity-based health planning and services

DHSDemographic health survey

GDHSGhana demographic health survey

GHSGhana health service

IPTIntermittent preventive treatment

ITNsInsecticide treated nets

MDGMillennium development goals

MTCTMother-to-child transmission

TBATraditional birth attendant

Electronic Supplementary MaterialThe online version of this article doi:10.1186-s12913-016-1654-5 contains supplementary material, which is available to authorized users.

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Author: Martin Amogre Ayanore - Milena Pavlova - Wim Groot


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