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333209
Continuum of care in a maternal, newborn and child health program in Ghana: Low completion rate and multiple obstacle factors


Tuesday, November 3, 2015 : 9:09 a.m. - 9:22 a.m.

Francis Yeji, Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
Shibanuma Akira, Department of Community and Global, HealthThe University of Tokyo, Tokyo, Japan
Abraham Oduro, Dr., Navrongo Health Research Centre, Navrongo, Ghana
Seth Owusu-Agyei, Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
Margaret Gyapong, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
Evelyn Ansah, Research and Development Division, Ghana Health Service, Accra, Ghana
Gloria Asare, Headquarters, Ghana Health Service, Accra, Ghana
Masamine Jimba, MPH, MD, PhD, Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Abraham Hodgson, Research and Development Division, Ghana Health Service, Accra, Ghana
  
Audio (mp3) recording Recorded Presentation (mp4)
Background: Slow progress has been made towards achieving MDGs 4 and 5 in Ghana. Ensuring continuum of care (CoC, minimum 4 antenatal visits - ANC4+; skilled assisted delivery; postnatal care - PNC within 48hours, at 2weeks and 6weeks) to mother and new-born is crucial in helping Ghana to achieve MDG 4 and 5 and beyond. We examined the levels and factors associated with CoC completion among Ghanaian women aged 15-49.

Methods: A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and new-born services usage along CoC. Multiple logistic regression models were used to assess factors associated with CoC completion.   

Results:Only 8.0% completed CoC; the greatest crack and contributor was detected between delivery and PNC within 48hours postpartum. About 95% of women had ANC4+ and PNC at 6weeks postpartum. Seventy five percent had skilled assisted delivery and 25% received PNC within 48hours. Factors associated with CoC completion at 95% confidence interval (CI) were: Location (OR=0.35, CI 0.13 - 0.39), marital status (OR=0.45; CI 0.22 - 0.95), education (OR=2.71; CI 1.11 - 6.57), transportation (OR=1.97; CI 1.07 - 3.62), and beliefs (OR=0.34; CI 0.21 - 0.61).  .  

Conclusion: Continuum of care completion rate is low in Ghana and efforts should focus on increasing postnatal care within 48hours and overcoming the known obstacles to increasing CoC completion rate.

Learning Areas:

Administration, management, leadership
Epidemiology
Public health or related public policy
Public health or related research

Learning Objectives:
Describe CoC complete rate among women aged 15-49year in Ghana Assess the factors associated with CoC completion among women aged 15-49year in Ghana Identify factors associated with CoC discontinuity among women aged 15-49year in Ghana

Keyword(s): Maternal and Child Health, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a Senior Researcher at Navrongo Health Research Centre, Ghana with over 10years experience, I currently coordinate the EMBRACE (Ensure Mothers and Babies Regular Access to Care) implementation research program in Ghana. I have great interest in improving maternal and child health in rural settings through research.
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.

Back to: 4048.0: Maternal Newborn and Child Health II