BackgroundIn recent years, caesarean section rates continue to evoke worldwide concern because of their steady increase, lack of consensus on the appropriate caesarean section rate and the associated short- and long-term risks.This study sought to identify the rate of caesarean section and associated factors in two districts in rural southern Ghana.MethodsPregnancy, birth, and socio-demographic information of 4948 women who gave birth between 2011 and 2013 were obtained from the database of Dodowa Health and Demographic Surveillance System. The rate of C-section was determined and the associations between independent and dependent variables were explored using logistic regression. The analyses were done in STATA 14.2 at 95% confidence interval.ResultsThe overall C-section rate for the study period was 6.59%. Women aged 30–34 years were more than twice likely to have C-section compared to those < 20 year (OR: 2.16, 95% CI: 1.20–3.90). However, women aged 34 years and above were more than thrice likely to undergo C-section compared to those < 20 year (OR: 3.73, 95% CI: 1.45–5.17).The odds of having C-section was 65 and 79% higher for participants with Primary and Junior High level schooling respectively (OR: 1.65, 95% CI: 1.08–2.51, OR:1.79, 95%CI: 1.19–2.70). The likelihood of having C-section delivery reduced by 60, 37, and 35% for women with parities 2, 3 and 3+ respectively (OR:0.60, 95% CI: 0.43–0.83, OR: 0.37, 95% CI: 0.25–0.56, OR:0.35, 95% CI: 0.25–0.54). There were increased odds of 36, 52, 83% for women who belong to poorer, middle, and richer wealth quintiles respectively (OR: 1.36, 95%CI: 0.85–2.18, OR: 1.52, 95% CI: 0.97–2.37, OR: 1.83, 95% CI: 1.20–2.80). Participants who belonged to the richest wealth quintile were more than 2 times more likely to have C-section delivery (OR: 2.14, 95%CI: 1.43–3.20). The odds of having C-section delivery reduced by 76% for women from Ningo-Prampram district (OR: 0.76, 95% CI: 0.59.0.96). Women whose household heads have Junior High level and above of education were 45% more likely to have C-section delivery (OR: 1.45, 95% CI: 1.09–1.93).ConclusionAge of mother, educational level, parity, household socioeconomic status, district of residence, and level of education of household head are associated with caesarean section delivery.

BackgroundLow birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. It also results in substantial costs to the health sector and imposes a significant burden on the society as a whole. This study seeks to investigate the determinants of low birth weight and the incidence of LBW in southern rural Ghana.MethodsPregnancy, birth, demographic and socioeconomic information of 6777 mothers who gave birth in 2011, 2012, and 2013 and information on their babies were extracted from a database. The database of Dodowa Health and Demographic Surveillance System is a longitudinal follow-up of over 24,000 households. The incidence of LBW was calculated and the univariable and multivariable associations between exposure variables and outcome were explored using logistic regression. STATA 11 was used for the analyses.ResultThe results revealed that 40.21 % of the infants were not weighed at birth and the incidence of LBW for 2011 to 2013 was 8.72, 7.04 and 7.52 % respectively. Women aged 20–24, 25–29, 30–34 years were more than twice more likely to have babies weighing ≥2.5 kg compared to those <20 years (OR:2.32, 95 % CI:1.65–3.26, OR:2.73, 95 % CI:1.96–3.79, OR:2.87, 95 % CI:2.06–4.01) and mothers who were >34 years were more than three times more likely to have babies weighed ≥2.5 kg (OR: 3.59, 95 % CI:2.56–5.04). Mothers who were civil servants were 77 % more likely to have babies weighed ≥2.5 kg (OR: 1.77, 95 % CI: 1.99–2.87) compared to those who were unemployed. After adjusting for other explanation variables, mothers from poorer households were 30 % more likely to have babies who weighed ≥2.5 kg (OR: 1.30, 95 % CI: 1.01–1.66) compared to those from the poorest households. Women with parity2 and parity > 3 were 30 % and 81 % more likely to have babies weighing ≥2.5 kg (OR: 1.30, 95 % CI: 1.03–1.63, OR: 1.81, 95 % CI: 1.38–2.35) compared to those with parity1. Male infants were 52 % more likely to weigh ≥2.5 kg at birth (OR: 1.52, 95 % CI: 1.32–1.76) compared to females.ConclusionOur study revealed that having infant birth weight ≥ 2.5 kg is highly associated with socioeconomic status of women household, the gender of an infant, parity, occupation and maternal age.

BackgroundMaternal mortality is the subject of the United Nations’ fifth Millennium Development Goal, which is to reduce the maternal mortality ratio by three quarters from 1990 to 2015. The giant strides made by western countries in dropping of their maternal mortality ratio were due to the recognition given to skilled attendants at delivery. In Ghana, nine in ten mothers receive antenatal care from a health professional whereas only 59 and 68% of deliveries are assisted by skilled personnel in 2008 and 2010 respectively. This study therefore examines the determinants of skilled birth attendant at delivery in rural southern Ghana.MethodsThis study comprises of 1874 women of reproductive age who had given birth 2 years prior to the study whose information were extracted from the Dodowa Health and Demographic Surveillance System. The univariable and multivariable associations between exposure variables (risk factors) and skilled birth attendant at delivery were explored using logistic regression.ResultsOut of a total of 1874 study participants, 98.29% of them receive antenatal care services during pregnancy and only 68.89% were assisted by skilled person at their last delivery prior to the survey. The result shows a remarkable influence of maternal age, level of education, parity, socioeconomic status and antenatal care attendance on skilled attendants at delivery.ConclusionAlthough 69% of women in the study had skilled birth attendants at delivery, women from poorest households, higher parity, uneducated, and not attending antenatal care and younger women were more likely to deliver without a skilled birth attendants at delivery. Future intervention in the study area to bridge the gap between the poor and least poor women, improve maternal health and promote the use of skilled birth at delivery is recommended.

Women and girls need proper sanitation and hygiene facilities to maintain health and dignity. In this study we show how schoolgirls from a peri-urban community of Ghana, experience severe multidimensional 'hygiene poverty' when attending schools. Hygiene poverty was characterized by poor water and sanitation infrastructures and serious social and emotional challenges, including shaming and disciplining of their sanitation and menstrual practices, which forces girls to apply secretive coping strategies. We discuss the importance of changing the negative MHM discourses at schools and fostering supportive teaching methods in adolescent female health.