Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey

Abstract

Background Home births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana. Methods Data for this study was obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. For the purpose of this study, a sample size of 2,101 women in the rural areas who had given birth within five years prior to the survey and had responses on variables was considered. Data processing, management and analysis were carried out using STATA version 14.0. This study carried out bivariate and multivariate analyses and results were tested at 95% confidence interval. The Adjusted odds ratios were used to present the results and the level of statistical significance was assessed using 95% confidence intervals. Results Home births was found to be high among women who resided in the Northern region compared to those in the Western region [AOR, 1.81 CI = 1.10–2.98]. Similarly, the likelihood of home birth was high among women with four or more births [AOR, 1.46 CI = 1.03–2.05] and Traditionalists [AOR, 2.50 CI = 1.54–4.06]. Conversely, giving birth at home was low among women with higher level of education [AOR = 0.58, CI = 0.43–0.78], those with rich wealth status [AOR = 0.19, CI = 0.10–0.38], those with four or more ANC visits [AOR = 0.11, CI = 0.15–0.23] and those who were covered by NHIS [AOR = 0.58, CI = 0.46–0.72]. Conclusions Over the years, there have been efforts by governments in Ghana to make maternal health services free in the country. However, a substantial proportion of women still undergo home births. To reduce the utilization of home births in Ghana, it is essential that government and non-governmental organisations make the cost of delivery services part of the free maternal health care policy and take into consideration the factors associated with the high rates of home births among rural women in Ghana.

Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

“…Educated women had less likelihood of home deliver as compared to uneducated women. The result was in line with the individual studies conducted in rural Ethiopia [26][27][28], Zimbabwe [29], Nigeria [30], Ghana [31,32], Guinea [23] and Nepal [33]. The reason for this might be due the fact that when mothers are educated it is more is likely to enhance female self-determination, positive attitude, and nancial freedom [34,35].…”

What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

“…Despite the importance of health facility delivery, some pregnant women in the country still deliver at home. Home delivery has been defined as any birth that had taken place in a pregnant woman’s home or the homes of other people [ 19 , 20 ]. In Ghana, several studies have shown that pregnant women who deliver at home often receive unskilled assistance during delivery [ 20 – 24 ].…”

“…Home delivery has been defined as any birth that had taken place in a pregnant woman’s home or the homes of other people [ 19 , 20 ]. In Ghana, several studies have shown that pregnant women who deliver at home often receive unskilled assistance during delivery [ 20 – 24 ]. Unskilled assistance has been defined as delivery assistance provided by traditional birth attendants (TBAs), relatives, and friends instead of skilled birth attendants (SBAs) such as doctors, physician assistants, midwives, or nurses [ 20 , 21 , 25 , 26 ].…”

“…Studies by Ganle et al [ 24 ] and Boah et al [ 23 ] in Northern Ghana and the Builsa South District of the Upper West region, respectively, identified fewer antenatal care visits, lack of health insurance, living in a male-headed household, being unexposed to media, parity, poor attitude of nurses, lack of transportation, cost of delivery kits, traditional beliefs and practices as predictors of home delivery. A recent study also identified women’s region of residence, educational status, wealth quintile, parity, religion, number of antenatal care (ANC) visits, and NHIS coverage as predictors of women’s use of home birth services [ 20 ]. However, these studies focused on women in rural areas [ 20 , 23 , 24 ], ignoring the fact that a considerable number of women in urban areas still deliver at home and receive unskilled assistance during delivery.…”

“…A recent study also identified women’s region of residence, educational status, wealth quintile, parity, religion, number of antenatal care (ANC) visits, and NHIS coverage as predictors of women’s use of home birth services [ 20 ]. However, these studies focused on women in rural areas [ 20 , 23 , 24 ], ignoring the fact that a considerable number of women in urban areas still deliver at home and receive unskilled assistance during delivery. The present study departs from the previous ones by assessing the factors associated with home delivery among women in urban areas in Ghana.…”