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. 2023 Mar 18;23(1):192.
doi: 10.1186/s12884-023-05504-w.

Non-adherence to WHO's recommended 8-contact model: geospatial analysis of the 2017 Maternal Health Survey

Kwamena Sekyi Dickson  1 , Ebenezer N K Boateng  2 , Kenneth Setorwu Adde  1 , Edward Kwabena Ameyaw  3   4 , Michelle L Munro-Kramer  5
Affiliations

Non-adherence to WHO's recommended 8-contact model: geospatial analysis of the 2017 Maternal Health Survey

Kwamena Sekyi Dickson et al. BMC Pregnancy Childbirth. .

Abstract

Introduction: Evidence shows that most women in Ghana do not meet the minimum 8-contact model for antenatal care as recommended by WHO with only 31.2%-41.9% of them meeting the recommendation. To the best of our knowledge, no study in Ghana has examined women's noncompliance with the WHO's recommended 8-contact model for antenatal care using geospatial analysis, as this study sets out to do.

Methods: We sourced data from the recent version of the Ghana Maternal Health Survey which was executed in 2017. A sample of 10,077 women with complete data participated in this study. The link between the explanatory variables and the outcome variable was investigated using binary and multivariate logistic regression models and Spatial analyses such as spatial autocorrelation (Moran's I), hotspot, cluster and outlier analysis, and geographically weighted regression were conducted using ArcMap version 10.7.

Results: Districts found in the north-eastern and south-western parts of the country were more likely to experience noncompliance with ANC. Women staying within the middle belt without health insurance were more likely (17-29%) to be noncompliant with ANC. Women with low community socioeconomic status were found to be more likely (17-34%) to be noncompliant with ANC in the eastern parts of Ghana.

Conclusion: The study has shown that in order to achieve targets one and three of Sustainable Development Goal 3, the government of Ghana, the Ministry of Health, together with the Ghana Health Service may have to intensify health education in the identified areas to highlight the importance of adherence to the WHO recommendations on ANC 8-contact model.

Keywords: Antenatal care; Geospatial analysis; Ghana; Reproductive health; Social demography; Women.

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Conflict of interest statement

Not applicable.

Figures

Fig. 1
Fig. 1
Hotspot analysis of ANC. Source: Computed from 2017 Maternal Health Survey
Fig. 2
Fig. 2
Cluster and Outlier of ANC. Source: Computed from 2017 Maternal Health Survey
Fig. 3
Fig. 3
Coefficient of Household size less than 5. Source: Computed from 2017 Maternal Health Survey
Fig. 4
Fig. 4
Coefficient of Marital status never in a union. Source: Computed from 2017 Maternal Health Survey
Fig. 5
Fig. 5
Coefficient of No NHIS. Source: Computed from 2017 Maternal Health Survey
Fig. 6
Fig. 6
Coefficient of Community Socioeconomic (Low). Source: Computed from 2017 Maternal Health Survey
Fig. 7
Fig. 7
Coefficient of Literacy Level (Low). Source: Computed from 2017 Maternal Health Survey
See this image and copyright information in PMC

References

    1. Ali N, Sultana M, Sheikh N, Akram R, Mahumud RA, Asaduzzaman M, Sarker AR. Predictors of optimal antenatal care service utilization among adolescents and adult women in Bangladesh. Health Serv Res Manage Epidemiol. 2018;28(5):2333392818781729. - PMC - PubMed
    1. Awotunde OT, Amole IO, Adesina SA, Adeniran A, OlaOlorun DA, Durodola AO, Awotunde TA. Pattern of antenatal care services utilization in a mission hospital in Ogbomoso South-west Nigeria. J Adv Med Pharm Sci. 2019;21(2):1–11.
    1. El-Khatib Z, KolawoleOdusina E, Ghose B, Yaya S. Patterns and predictors of insufficient antenatal care utilization in Nigeria over a decade: a pooled data analysis using demographic and health surveys. Int J Environ Res Public Health. 2020;17(21):8261. doi: 10.3390/ijerph17218261. - DOI - PMC - PubMed
    1. Finlayson K, Downe S. Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies. PLoS Med. 2013;10(1):e1001373. doi: 10.1371/journal.pmed.1001373. - DOI - PMC - PubMed
    1. Tessema ZT, Teshale AB, Tesema GA, Tamirat KS. Determinants of completing recommended antenatal care utilization in sub-Saharan from 2006 to 2018: evidence from 36 countries using Demographic and Health Surveys. BMC Pregnancy Childbirth. 2021;21(1):1–2. doi: 10.1186/s12884-021-03669-w. - DOI - PMC - PubMed

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