Determinants and Correlates of Skilled Attendance at Delivery in Ghana: Evidence from the 2007 Ghana Maternal Mortality Survey

As the countdown to the target date of the Millennium Development Goals begins, progress towards reducing maternal mortality in sub-Saharan Africa still lacks far behind other developing regions of the world. Skilled attendance at birth has been shown to reduce maternal mortality and morbidity. Yet, although 96 percent of pregnant women in Ghana receive antenatal care just over 1in 2 births are attended to by a skilled health provider. In this study, we examine the correlates and determinants of skilled assistance at delivery using data drawn from the Ghana Maternal Mortality Study conducted in 2007. We investigate the role of social and bio-demographic characteristics and the number of antenatal care visits as well as the quality of care received during the pregnancy of the last born child on skilled attendance at delivery. Using multinomial logit models, we find that although household and individual socio-demographic factors are significant predictors of assistance at delivery, the number of antenatal visits and the timing of the first visit as well as the quality of care received during pregnancy, have a large and independent effect on skilled assistance at delivery. This strong positive association implies that increasing the quality and timing of antenatal care could be useful for the proportion of births attended to by skilled providers. The implications of these findings as they relate to maternal mortality in resourced constrained settings such as Ghana are discussed.