Non-adherence to WHO’s recommended antenatal care visits: Geospatial analysis of the 2017 Maternal Health Survey

Abstract

Introduction: Evidence shows that most women in Ghana do not meet the minimum antenatal care visits as recommended by WHO with only 31.2%-41.9% of them meeting the recommendation. To the best of our knowledge, no study in Ghana has examined women’s noncompliance with the WHO’s recommended eight antenatal visits using geospatial analysis, as this study sets out to do. Methods We sourced data from the recent version of the Ghana Maternal Health Survey which was executed in 2017. A sample of 10,077 women with complete data participated in this study. The link between the explanatory variables and the outcome variable was investigated using binary and multivariate logistic regression models and Spatial analyses such as spatial autocorrelation (Moran's I), hotspot, cluster and outlier analysis, and geographically weighted regression were conducted using ArcMap version 10.7. Results Districts found in the north-eastern and south-western parts of the country were more likely to experience noncompliance with ANC. Women staying within the middle belt without health insurance were more likely (17–29%) to be noncompliant with ANC. Women with low community socioeconomic status were found to be more likely (17–34%) to be noncompliant with ANC in the eastern parts of Ghana. Conclusion The study has shown that in order to achieve targets one and three of Sustainable Development Goal 3, the government of Ghana, the Ministry of Health, together with the Ghana Health Service may have to intensify health education in the identified areas to highlight the importance of adherence to the WHO recommendations on ANC visits.

Endorsement of Spousal Sexual Violence Across Gender: Evidence from Zambia Demographic and Health Survey

“…Finally, the present study showed that men in rich category had lower likelihood of endorsing SSV. This is consistent with previous research, although such observations were found in both men and women [77]. When men can handle the financial burden of their families, they may experience fewer frustrations and irritations that often lead to perpetration of IPV [102,103].…”

“…In the present study, first, it was indicated that 36.5% of the women and 11.5% of men endorsed SSV in Zambia. This is consistent with prior studies within Zambia and other African countries that found women to be more likely to approve of IPV, including SSV, which was termed as "wife beating" [14,40,43,77]. Despite this, the lower prevalence rates of endorsing SSV among men should not be mistaken for decreased occurrences of SSV.…”

“…This observation highlights the enduring influence of cultural norms perpetuating male dominance, control, and privilege over women. This also underscores the limited progress in combating gender inequality, which remains highly prevalent in Zambian society [14,77,80,81].…”

“…In many cultural contexts, being a woman in a marriage can increases the feelings of powerlessness, vulnerability, and limited decision-making abilities. This is particularly true in societies such as Zambia where women hold subordinate positions or rely on men for financial support [14,77]. As a result, women may be able to tolerate or accept various forms of SSV in order to preserve their marriages as a means of survival, disregarding the potential long-term physical and psychological consequences.…”

“…In contrast, only men with primary education were found to have a higher likelihood of endorsing SSV. Previous studies conducted in various African countries consistently highlights the importance of education in promoting selfconfidence, self-reliance, decision-making, empowerment, autonomy, and liberation for women, and effectively combating women suppression from IPV [77,86,87]. This emphasizes the vital role of education as a preventive measure that can foster positive attitudes and behaviors, particularly in marital or intimate relationships to deter tolerance of SSV.…”