Trends and changes in home deliveries in Kassena-Nankana districts in northern Ghana: Results from repeated cross-sectional surveys

Abstract

Objective: To investigate trends and changes in home deliveries in northern Ghana following the implementation of interventions targeting common barriers to utilization of health services.

Methods: Data collected through repeated cross-sectional surveys conducted in the Kassena-Nankana east and west districts from 2003-2009 were used in a secondary analysis. All childbirths that occurred in this period were included. Univariate time series were used to describe trends in home deliveries. Significant trends were investigated using the χ² test for trends, and changes in inequalities across subgroups were assessed by fitting simple linear regressions.

Results: A total of 25 539 deliveries were recorded, of which 58.1% occurred at home. The incidence of home deliveries declined from 69.1% in 2003 to 36.5% in 2009 (P<0.001). This declining pattern was consistently observed within all subgroups defined by wealth index, and educational and residential status. Larger declines were observed in poor and rural residents compared with rich and urban residents (P<0.001).

Conclusion: The incidence of home deliveries halved during the study period and there was a significant reduction in previous inequalities.

Keywords: Cross-sectional survey; Ghana; Home deliveries; Trends.