Equity and access to maternal and child health services in Ghana a cross-sectional study

Abstract

Background Inequities in the distribution of and access to maternal and child health care services is pervasive in Ghana. Understanding the drivers of inequity in maternal and child health (MCH) is important to achieving the universal health coverage component of the Sustainable Development Goals (SDGs) and poverty reduction in developing countries. However, there is increasing disparities in MCH services, especially in rural -urban, and income quintiles. The study aimed to examine the disparities in maternal and child health care services in Ghana for policy intervention. Methods Data for this study was extracted from the nationally representative Ghana Statistical Service (GSS) Multiple Indicator Cluster Survey (MICS) round 4, 2011. Respondents of this survey were women of reproductive age 15–49 years with a sample size of 10,627 households. The models were estimated using multivariate regression analysis together with concentration index (CI) and risk ratio (RR) to assess the distribution of MCH indicator groups across the household wealth index. Results The results show that women with secondary school level and above were more likely to receive family planning, prenatal care, and delivery by a skilled health professional than those without formal education. Mothers with low level of educational attainment were 87% more likely to have their first pregnancy before the age of 20 years, and 78% were more likely to have children with under-five mortality, and 45% more likely to have children who had diarrhoea. teenage pregnancy (CI = − 0.133, RR =0.679), prenatal care by skilled health worker (CI = − 0.124, RR =0.713) under five mortality, child underweight, reported diarrhoea, and suspected pneumonia, though not statistically significant, were more concentrated in the poorer than in the richer households, The RR between the top and bottom quintiles ranged from 0.77 for child underweight to 0.82 for child wasting. Conclusion Geographic location, income status and formal education are key drivers of maternal and child health inequities in Ghana. Government can partner the private sector to implement health policies to address inequalities in MCH services through primary health care, and resource allocation skewed towards rural areas and the lower wealth quintile to bridge the inequality gaps and improve MCH outcomes. The government and the private sectors should prioritize female education, as that can improve maternal and child health.

Trends of risk factors associated with childhood stunting and anaemia in Ghana: evidence from the Demographic Health Survey and Multiple Indicator Cluster Survey (2003–2017)

“…Furthermore, to reduce the risk and occurrence of adverse birth outcomes such as low birth weight and childhood illnesses amongst children, policies such as the National Health Insurance Scheme (NHIS) have been rolled out to improve maternal healthcare services ( 41 ) . However, whilst this scheme was mandated to also help decrease socio-economic inequalities in healthcare utilisation within the country, studies have highlighted the existence of inequalities ( 42 , 43 ) .…”

Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana

“…This is not surprising because there exist great disparities and inequalities in access and distribution of maternal and child care services in rural-urban communities. 17 Forestalling deaths by asphyxia and infections should be focused, while essential post-delivery care and wellbeing of neonates prioritized. 18 …”

Inequalities of Infant Mortality in Ethiopia

“…Therefore, addressing social determinants of health is crucial to achieving health equity and reducing health inequalities, including inequalities in infant mortalities. Thus, the context-specific exploration of inequality in infant mortality is needed, which identifies determinants of health inequality, and further provides policy makers with insight into designing policies to enhance health justice so that every child has an equal opportunity to achieve good health [ 8 , 9 , 10 , 11 ]. In this context, we took the example of Ethiopia to examine inequalities in infant mortality using nationally representative samples.…”