Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana

Low Completion Rate and Multiple Obstacle Factors

Ghana EMBRACE Implementation Research Project Team

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 1549. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.130.39), marital status (OR = 0.45; CI 0.220.95), education (OR = 2.71; CI 1.116.57), transportation (OR = 1.97; CI 1.073.62), and beliefs about childhood illnesses (OR = 0.34; CI0.210.61). Conclusion The continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.

Original languageEnglish
Article numbere0142849
JournalPloS one
Volume10
Issue number12
DOIs
Publication statusPublished - Dec 1 2015

Fingerprint

Ghana
Continuity of Patient Care
Logistics
neonates
Postnatal Care
Education
Health
Sampling
marital status
Geographical Locations
childhood
cross-sectional studies
education
Postpartum Period
Logistic Models
Mothers
Newborn Infant
Maternal Health
Infant Health
Child Health

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana : Low Completion Rate and Multiple Obstacle Factors. / Ghana EMBRACE Implementation Research Project Team.

In: PloS one, Vol. 10, No. 12, e0142849, 01.12.2015.

Research output: Contribution to journalArticle

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title = "Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors",
abstract = "Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 1549. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0{\%} had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95{\%} of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75{\%} had skilled assisted delivery and 25{\%} received postnatal care within 48 hours. Factors associated with CoC completion at 95{\%} CI were geographical location (OR = 0.35, CI 0.130.39), marital status (OR = 0.45; CI 0.220.95), education (OR = 2.71; CI 1.116.57), transportation (OR = 1.97; CI 1.073.62), and beliefs about childhood illnesses (OR = 0.34; CI0.210.61). Conclusion The continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.",
author = "{Ghana EMBRACE Implementation Research Project Team} and Francis Yeji and Akira Shibanuma and Abraham Oduro and Cornelius Debpuur and Kimiyo Kikuchi and Seth Owusu-Agei and Kimiyo Kikuchi and Sumiyo Okawa and Evelyn Ansah and Asare, {Gloria Quansah} and Keiko Nanishi and John Williams and Sheila Addei and Charlotte Tawiah and Junko Yasuoka and Yeetey Enuameh and Evelyn Sakeah and Peter Wontuo and Masamine Jimba and Abraham Hodgson and Yoshiharu Yoneyama and Ebenezer Appiah-Denkyira and Ansah, {Evelyn Korkor} and Vida Kukula and Doris Sarpong and Clement Narh and Seth Owusu-Agyei and Kwaku Poku-Asante and Kwame Adjei and Emmanuel Mahama and Oduro, {Abraham Rexford} and Akiko Hagiwara and Sakiko Shiratori and Yusuke Kamiya",
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T2 - Low Completion Rate and Multiple Obstacle Factors

AU - Ghana EMBRACE Implementation Research Project Team

AU - Yeji, Francis

AU - Shibanuma, Akira

AU - Oduro, Abraham

AU - Debpuur, Cornelius

AU - Kikuchi, Kimiyo

AU - Owusu-Agei, Seth

AU - Kikuchi, Kimiyo

AU - Okawa, Sumiyo

AU - Ansah, Evelyn

AU - Asare, Gloria Quansah

AU - Nanishi, Keiko

AU - Williams, John

AU - Addei, Sheila

AU - Tawiah, Charlotte

AU - Yasuoka, Junko

AU - Enuameh, Yeetey

AU - Sakeah, Evelyn

AU - Wontuo, Peter

AU - Jimba, Masamine

AU - Hodgson, Abraham

AU - Yoneyama, Yoshiharu

AU - Appiah-Denkyira, Ebenezer

AU - Ansah, Evelyn Korkor

AU - Kukula, Vida

AU - Sarpong, Doris

AU - Narh, Clement

AU - Owusu-Agyei, Seth

AU - Poku-Asante, Kwaku

AU - Adjei, Kwame

AU - Mahama, Emmanuel

AU - Oduro, Abraham Rexford

AU - Hagiwara, Akiko

AU - Shiratori, Sakiko

AU - Kamiya, Yusuke

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 1549. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.130.39), marital status (OR = 0.45; CI 0.220.95), education (OR = 2.71; CI 1.116.57), transportation (OR = 1.97; CI 1.073.62), and beliefs about childhood illnesses (OR = 0.34; CI0.210.61). Conclusion The continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.

AB - Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 1549. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.130.39), marital status (OR = 0.45; CI 0.220.95), education (OR = 2.71; CI 1.116.57), transportation (OR = 1.97; CI 1.073.62), and beliefs about childhood illnesses (OR = 0.34; CI0.210.61). Conclusion The continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.

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