Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017;10(1):1291879.
doi: 10.1080/16549716.2017.1291879.

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Evelyn Sakeah  1 , Sumiyo Okawa  2 , Abraham Rexford Oduro  3 , Akira Shibanuma  2 , Evelyn Ansah  4 , Kimiyo Kikuchi  2 , Margaret Gyapong  5 , Seth Owusu-Agyei  6 , John Williams  7 , Cornelius Debpuur  1 , Francis Yeji  1 , Vida Ami Kukula  8 , Yeetey Enuameh  9 , Gloria Quansah Asare  10 , Enoch Oti Agyekum  11 , Sheila Addai  12 , Doris Sarpong  13 , Kwame Adjei  9 , Charlotte Tawiah  14 , Junko Yasuoka  2 , Keiko Nanishi  15 , Masamine Jimba  2 , Abraham Hodgson  16 , The Ghana Embrace Team
Affiliations

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Evelyn Sakeah et al. Glob Health Action. 2017.

Abstract

Background: Improving maternal health is a global challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Antenatal care (ANC) attendance is known to improve maternal health. However, few studies have updated current knowledge regarding determinants of ANC attendance.

Objective: This study examined factors associated with ANC attendance in predominantly rural Ghana.

Methods: We conducted a cross-sectional study at three sites (i.e. Navrongo, Kintampo, and Dodowa) in Ghana between August and September 2013. We selected 1500 women who had delivered within the two years preceding the survey (500 from each site) using two-stage random sampling. Data concerning 1497 women's sociodemographic characteristics and antenatal care attendance were collected and analyzed, and factors associated with attending ANC at least four times were identified using logistic regression analysis.

Results: Of the 1497 participants, 86% reported attending ANC at least four times, which was positively associated with possession of national health insurance (AOR 1.64, 95% CI: 1.14-2.38) and having a partner with a high educational level (AOR 1.64, 95% CI: 1.02-2.64) and negatively associated with being single (AOR 0.39, 95% CI: 0.22-0.69) and cohabiting (AOR 0.57, 95% CI: 0.34-0.97). In site-specific analyses, factors associated with ANC attendance included marital status in Navrongo; marital status, possession of national health insurance, partners' educational level, and wealth in Kintampo; and preferred pregnancy timing in Dodowa. In the youngest, least educated, and poorest women and women whose partners were uneducated, those with health insurance were more likely to report at least four ANC attendances relative to those who did not have insurance.

Conclusions: Ghanaian women with low socioeconomic status were less likely to report at least four ANC attendances during pregnancy if they did not possess health insurance. The national health insurance scheme should include a higher number of deprived women in predominantly rural communities.

Keywords: Ghana; Maternal mortality; antenatal care; determinants; women service utilization.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Map of Ghana showing the geographical location of the study sites. Source: http://www2m.biglobe.ne.jp/ZenTech/world/map/Ghana/Outline_Map_of_Ghana.htm.
See this image and copyright information in PMC

References

    1. World Health Organization Trends in maternal mortality: 1990 to 2015. WHO. [cited 2016. May 13]. Available from: www.who.int/reproductivehealth/…/maternal-mortality-2015/en/http://www.w...
    1. Ghana Statistical Service, Ghana Health Service, and ICF Macro Ghana demographic and health survey 2014 Key Indicators. Accra, Ghana; 2015. April Available from: http://www.statsghana.gov.gh/docfiles/DHS_Report/Ghana_DHS_2014-KIR-21_M...
    1. World Health Organization, United Nations Population Fund, United Nations International Children’s Emergency Fund, The World Bank. Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice (3rd edition). World Health Organization. [cited 2016. July 13]. Available from: http://www.who.int/maternal_child_adolescent/documents/924159084x/en/
    1. Arthur E. Wealth and antenatal care use: implications for maternal health care utilisation in Ghana. Health Econ Rev. 2012;2:14. - PMC - PubMed
    1. Magadi MA, Madise NJ, Rodrigues RN. Rodrigues RN: frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities. Soc Sci Med. 2000;51:551–11. - PubMed

LinkOut - more resources