High antenatal care but low skilled attendance at birth: What are underlying the health system factors?
Aim: This study examines factors associated with use of SBAs among women who attend ANC in Ghana, focusing on the mediating role of ANC quality.
Methods: Data are from the Ghana Maternal Health Survey (N=4,868). Quality of antenatal care is measured by an index based on receipt (or otherwise) of nine essential antenatal services during the last pregnancy. Analytic techniques include multilevel linear regression with mediation analysis to examine intervening effects.
Results: Among women who go for an ANC visit, those who receive higher quality ANC are more likely to deliver with a SBA than those who receive lower quality ANC. Urban residence, higher SES, frequent ANC visits, and receiving ANC in a higher-level or private health facility increases the odds of delivering with a SBA. ANC quality partially mediates the effects of these factors on use of SBAs.
Implications: Targeted policies and programs to increase ANC quality, especially in the lower-level health facilities and among low SES women, will help improve coverage and reduce disparities in use of SBAs.
Learning Areas:Program planning
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Identify the factors associated with use of skilled birth attendants among women who receive some antenatal care Analyze if quality of antenatal care is associated with use of skilled birth attendants net of other factors Evaluate if disparities in quality of antenatal care explain some of the socioeconomic and rural/urban disparities in use of skilled birth attendants
Keyword(s): International MCH, Quality of Care
Qualified on the content I am responsible for because: I am currently a PhD Candidate in the Department of Community Health Sciences at UCLA School of Public Health. I am also from Ghana where I was trained as a medical doctor. My area of specialty is maternal and child health. I conceived the study, conducted the analyses, and wrote up the content of this abstract.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.