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

and the Ghana EMBRACE Team

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Article number1291879
JournalGlobal health action
Volume10
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Ghana
Prenatal Care
Cross-Sectional Studies
National Health Programs
Marital Status
Health Insurance
Pregnancy
Maternal Mortality
Rural Population
Insurance
Social Class
Statistical Factor Analysis
Logistic Models
Regression Analysis
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Determinants of attending antenatal care at least four times in rural Ghana : analysis of a cross-sectional survey. / and the Ghana EMBRACE Team.

In: Global health action, Vol. 10, No. 1, 1291879, 01.01.2017.

Research output: Contribution to journalArticle

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title = "Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey",
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.",
author = "{and the Ghana EMBRACE Team} and Evelyn Sakeah and Sumiyo Okawa and Oduro, {Abraham Rexford} and Akira Shibanuma and Evelyn Ansah and Kimiyo Kikuchi and Margaret Gyapong and Seth Owusu-Agyei and John Williams and Cornelius Debpuur and Francis Yeji and Kukula, {Vida Ami} and Yeetey Enuameh and Asare, {Gloria Quansah} and Agyekum, {Enoch Oti} and Sheila Addai and Doris Sarpong and Kwame Adjei and Charlotte Tawiah and Junko Yasuoka and Keiko Nanishi and Masamine Jimba and Abraham Hodgson and Ebenezer Appiah-Denkyira and Yusuke Kamiya",
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AU - and the Ghana EMBRACE Team

AU - Sakeah, Evelyn

AU - Okawa, Sumiyo

AU - Oduro, Abraham Rexford

AU - Shibanuma, Akira

AU - Ansah, Evelyn

AU - Kikuchi, Kimiyo

AU - Gyapong, Margaret

AU - Owusu-Agyei, Seth

AU - Williams, John

AU - Debpuur, Cornelius

AU - Yeji, Francis

AU - Kukula, Vida Ami

AU - Enuameh, Yeetey

AU - Asare, Gloria Quansah

AU - Agyekum, Enoch Oti

AU - Addai, Sheila

AU - Sarpong, Doris

AU - Adjei, Kwame

AU - Tawiah, Charlotte

AU - Yasuoka, Junko

AU - Nanishi, Keiko

AU - Jimba, Masamine

AU - Hodgson, Abraham

AU - Appiah-Denkyira, Ebenezer

AU - Kamiya, Yusuke

PY - 2017/1/1

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N2 - 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.

AB - 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.

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