TY - JOUR
T1 - Factors influencing health facility delivery in predominantly rural communities across the three ecological zones in Ghana
T2 - A cross-sectional study
AU - Ghana EMBRACE Implementation Research Project Team
AU - Enuameh, Yeetey Akpe Kwesi
AU - Okawa, Sumiyo
AU - Asante, Kwaku Poku
AU - Kikuchi, Kimiyo
AU - Mahama, Emmanuel
AU - Ansah, Evelyn
AU - Tawiah, Charlotte
AU - Adjei, Kwame
AU - Shibanuma, Akira
AU - Nanishi, Keiko
AU - Yeji, Francis
AU - Agyekum, Enoch Oti
AU - Yasuoka, Junko
AU - Gyapong, Margaret
AU - Oduro, Abraham Rexford
AU - Asare, Gloria Quansah
AU - Hodgson, Abraham
AU - Jimba, Masamine
AU - Owusu-Agyei, Seth
AU - Yoneyama, Yoshiharu
AU - Appiah-Denkyira, Ebenezer
AU - Addei, Sheila
AU - Kukula, Vida
AU - Sarpong, Doris
AU - Narh, Clement
AU - Williams, John
AU - Debpuur, Cornelius
AU - Sakeah, Evelyn
AU - Wontuo, Peter
AU - Hagiwara, Akiko
AU - Shiratori, Sakiko
AU - Kamiya, Yusuke
N1 - Funding Information:
The Ghana EMBRACE Implementation Research Project is conducted and funded by the Government of the Republic of Ghana, Japan International Cooperation Agency (JICA) Human Development Department, and JICA Research Institute ( http://www.jica.go.jp/english/index.html ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. System Science Consultants is a project coordination team member of the study. It is not a funder and also has no conflicting interest on the outcome of the study.
Funding Information:
The Ghana EMBRACE Implementation Research Project was conducted by the Government of the Republic of Ghana, Japan International Cooperation Agency (JICA) Human Development Department, and JICA Research Institute with a coordinating support from the System Science Consultancy Inc.
Publisher Copyright:
© 2016 Enuameh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana. Methods: Data were collected from 1,500 women aged 15-49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models. Results: Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider's influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96-30.48), place of residence (AOR = 4.49; 95% CI 1.14-17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29-2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43-5.60). Conclusion: In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider's influence. Ensuring care provider's counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana.
AB - Background: Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana. Methods: Data were collected from 1,500 women aged 15-49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models. Results: Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider's influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96-30.48), place of residence (AOR = 4.49; 95% CI 1.14-17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29-2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43-5.60). Conclusion: In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider's influence. Ensuring care provider's counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana.
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U2 - 10.1371/journal.pone.0152235
DO - 10.1371/journal.pone.0152235
M3 - Article
C2 - 27031301
AN - SCOPUS:84977654174
SN - 1932-6203
VL - 11
JO - PLoS One
JF - PLoS One
IS - 3
M1 - e0152235
ER -
