Socio-demographic determinants of skilled birth attendant at delivery in rural southern Ghana

Abstract

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.

Factors associated with the timing of antenatal clinic attendance among first-time mothers in rural southern Ghana

“…Determination of socioeconomic status as a proxy measure of a household's long term standard of living using calculated weights based on principal component analysis (PCA) [23] has been reported elsewhere [20,24].…”

Understanding factors influencing home delivery in the context of user‐fee abolition in Northern Ghana: Evidence from 2014 DHS

“…In both public health and social science literatures in diverse contexts, several studies have identified numerous factors contributing to home deliveries, including socio‐demographic, maternal, socio‐cultural, economic, health system, and geographical factors . Studies have shown that mothers' socio‐demographic characteristics, such as educational status, occupation, and residential area, influence their choice of place of delivery .…”

“…Other factors include socio‐cultural factors such as preferences for traditional birth attendants (TBAs), the influence of mothers‐in‐law, and beliefs that health facility delivery is a sign of weakness or marital infidelity . Economic factors such as low socio‐economic status and lack of health insurance have also been implicated. Health system factors including poor attitude of health care providers in Ghana, intimidation, unfriendliness and cultural insensitivity displayed by some health care providers in health care facilities in Ghana, poor quality of care alongside long distances to health care facilities in Ghana, and informal payments even in the context of user‐fee exemption for skilled delivery services also influence home delivery …”

“…10 In both public health and social science literatures in diverse contexts, several studies have identified numerous factors contributing to home deliveries, including socio-demographic, maternal, socio-cultural, economic, health system, and geographical factors. [11][12][13][14] Studies have shown that mothers' socio-demographic characteristics, such as educational status, occupation, and residential area, influence their choice of place of delivery. [15][16][17] In different contexts, it has been shown that the educational status of the pregnant woman does influence the woman's perception of home delivery and health seeking behaviour.…”

“…19 Other factors include socio-cultural factors such as preferences for traditional birth attendants (TBAs), 18,24 the influence of mothers-in-law, 24 and beliefs that health facility delivery is a sign of weakness or marital infidelity. 13,25,26 Economic factors such as low socio-economic status 14 and lack of health insurance 22 have also been implicated.…”