Evaluating the Impact of the Community-Based Health Planning and Services Initiative on Uptake of Skilled Birth Care in Ghana

Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoë; Harfoot, Andrew; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W.; Falkingham, Jane; Atkinson, Peter M.

doi:10.1371/journal.pone.0120556

Cited by 53 publications

(74 citation statements)

References 17 publications

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“…The high presence of CHPS in the region may be contributing substantially to the observed pattern. The relevance of CHPS in improving maternal and child health in Ghana has been highlighted previously [35, 36], suggesting that physical access is equally an important drive towards facility-based deliveries.…”

Section: Discussionmentioning

confidence: 91%

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Ameyaw

Tanle

Kissah-Korsah

et al. 2016

International Journal of Reproductive Medicine

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Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women's health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09–1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59–0.84] and those having final say on visits [OR = 0.86, CI = 0.73–1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

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Section: Discussionmentioning

confidence: 91%

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Ameyaw

Tanle

Kissah-Korsah

et al. 2016

International Journal of Reproductive Medicine

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“…The key innovation of FANC to shift attention from risk categorization to focused care and maternal health at large has proved to be a master stroke toward the improvement of maternal health. The household visits component of CHPS, incorporated into FANC implementation, ensures a systematic and significant improvement in access, with clients being reached at their homes instead of having to make trips sometimes exceeding 10 kilometers to access care [36].…”

Section: Discussionmentioning

confidence: 99%

Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

Haruna

Dandeebo

Galaa

2019

Advances in Public Health

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Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.

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“…Geographical proximity to health facilities is a known determinant of both access to maternal care [1–3] and better maternal outcomes [4, 5]. These improved outcomes have been attributed to improved access and utilization of antenatal care, as well as of delivery in health facilities that have skilled birth attendants [6–8].…”

Section: Introductionmentioning

confidence: 99%

Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

et al. 2017

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BackgroundGeographic proximity to health facilities is a known determinant of access to maternal care. Methods of quantifying geographical access to care have largely ignored the impact of precipitation and flooding. Further, travel has largely been imagined as unimodal where one transport mode is used for entire journeys to seek care. This study proposes a new approach for modeling potential spatio-temporal access by evaluating the impact of precipitation and floods on access to maternal health services using multiple transport modes, in southern Mozambique.MethodsA facility assessment was used to classify 56 health centres. GPS coordinates of the health facilities were acquired from the Ministry of Health while roads were digitized and classified from high-resolution satellite images. Data on the geographic distribution of populations of women of reproductive age, pregnancies and births within the preceding 12 months, and transport options available to pregnant women were collected from a household census. Daily precipitation and flood data were used to model the impact of severe weather on access for a 17-month timeline. Travel times to the nearest health facilities were calculated using the closest facility tool in ArcGIS software.ResultsForty-six and 87 percent of pregnant women lived within a 1-h of the nearest primary care centre using walking or public transport modes respectively. The populations within these catchments dropped by 9 and 5% respectively at the peak of the wet season. For journeys that would have commenced with walking to primary facilities, 64% of women lived within 2 h of life-saving care, while for those that began journeys with public transport, the same 2-hour catchment would have contained 95% of the women population. The population of women within two hours of life-saving care dropped by 9% for secondary facilities and 18% for tertiary facilities during the wet season.ConclusionsSeasonal variation in access to maternal care should not be imagined through a dichotomous and static lens of wet and dry seasons, as access continually fluctuates in both. This new approach for modelling spatio-temporal access allows for the GIS output to be utilized not only for health services planning, but also to aid near real time community-level delivery of maternal health services.

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Evaluating the Impact of the Community-Based Health Planning and Services Initiative on Uptake of Skilled Birth Care in Ghana

Cited by 53 publications

References 17 publications

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

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