Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113272

Fiifi Amoako Johnson¹, James John Brown¹, and Sabu S. Padmadas, PhD². (1) Division of Social Statistics, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, United Kingdom, 00 44 80 595 832, faj100@socsci.soton.ac.uk, (2) Division of Social Statistics, School of Social Sciences, University of Southampton, UK, Highfield, Southampton, SO 17 1BJ, Southampton, United Kingdom

Background: Poor utilization of maternal health services have been identified as one of the determinants of high maternal and infant mortality in Sub Saharan Africa. The recent Ghana Demographic and Health Survey (GDHS) showed that about 54% of deliveries take place at home under unhygienic surroundings in the presence of untrained birth attendants.

Objective: This study aimed to investigate the spatial variations within and across communities on the utilization of delivery care services in Ghana.

Methods: Data from the 1998 and 2003 GDHS and the 2000 Ghana Population and Housing Census have been used to identify the individual and contextual level factors that explain the levels of unobserved heterogeneity associated with choice of delivery care services. Multilevel multinomial logistic regression techniques were used for the analysis that considered 2,342 and 2,757 mothers who had a birth in the last 5 years preceding the 1998 and 2003 surveys respectively.

Findings: The heterogeneity in delivery care utilization in public sectors was found persistently higher between rural communities in the 1998 and 2003 periods when compared to those in urban areas. In urban areas, public sector delivery care deteriorated in particularly those communities where service provisions were already poorer when compared to communities with better care [ƒÝij=0.41 (SE: 0.23) in 1998 and ƒÝij=1.47 (SE:0.24) in 2003]. The variations in the community effects were found highly significant (p<0.001) when statistically controlled for individual characteristics.

Conclusions: Clustering effects were highly significant with regard to utilization of delivery care services especially within rural communities.

Learning Objectives:

• This study aimed to investigate the spatial variations within and across communities on the utilization of delivery care services in Ghana.

Keywords: Maternal Health, Health Care Access

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.