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

Ganle, John Kuumuori; Mahama, Musah Salifu; Maya, Ernest; Manu, Adom; Torpey, Kwasi; Adanu, Richard

doi:10.1002/hpm.2731

Cited by 24 publications

(26 citation statements)

References 34 publications

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“…For instance, a study in Guinea found a prevalence of 61.8% home deliveries among women [ 38 ]. Other studies in Ghana [ 34 ], Nigeria [ 39 ] and Ethiopia [ 32 ], identified a prevalence of 59, 62 and 67.2% of home deliveries among women respectively. The disparities in prevalence of home delivery in this study, compared to other previous studies could be due to differences in study population and samples.…”

Section: Discussionmentioning

confidence: 99%

“…Low socio-economic status, manifested in lack of formal education for both woman and partner, poorest wealth quintile and rural dwelling was linked with a higher likelihood of home delivery. Previous studies have also found factors such as lower wealth quintile [ 23 , 34 , 43 , 44 ], lack of education [ 45 – 48 ] and rural dwelling [ 44 , 49 , 50 ] as predictors of home delivery. In most of these studies, the possible reasons provided for the increased likelihood of home delivery among these cohorts of pregnant women is financial and geographical barriers to accessing health facility deliveries.…”

Section: Discussionmentioning

confidence: 99%

“…Healthcare decision making was coded as alone and not alone and male and female were used as description for sex of household head. These variables were chosen due to their significant associations with non-utilization of health facility delivery in previous studies in SSA [ 12 , 32 – 34 ].…”

Section: Methodsmentioning

confidence: 99%

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Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Ahinkorah

2020

BMC Health Serv Res

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Background Many childbearing women in sub-Saharan African countries like Guinea still face challenges accessing and utilizing health facility delivery services and opt to deliver at home. This study examined the non-utilization of health facility delivery and its associated factors among childbearing women in Guinea. Methods Data from the 2018 Guinea Demographic and Health Survey was used in this study. Data of 5406 childbearing women were analysed using STATA version 14.2 by employing a multilevel logistic regression approach. The results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results More than three-quarters (47.6%) of childbearing women in Guinea did not deliver at health facilities. Women who had no formal education (aOR = 1.52, 95% CI = 1.09–2.12), those whose partners had no formal education (aOR = 1.25, 95% CI =1.01–1.56), those whose pregnancies were unintended (aOR = 1.40, 95% CI =1.13–1.74) and those who were Muslims (aOR = 2.87, 95% CI =1.17–7.08) were more likely to deliver at home. Furthermore, women with parity four or more (aOR = 1.78, 95% CI =1.34–2.37), those who listened to radio less than once a week (aOR = 5.05, 95% CI =1.83–13.89), those who never watched television (aOR = 1.46, 95% CI =1.12–1.91), those with poorest wealth quintile (aOR = 4.29, 95% CI =2.79–6.60), women in female-headed households (aOR = 1.38, 95% CI =1.08–1.78) and rural dwellers (aOR = 3.86, 95% CI =2.66–5.60) were more likely to deliver at home. Conclusion This study has identified low socio-economic status, inadequate exposure to media, having an unplanned pregnancy and religious disparities as key predictors of home delivery among childbearing women in Guinea. The findings call for the need to enhance advocacy and educational strategies like focus group discussions, peer teaching, mentor-mentee programmes at both national and community levels for women to encourage health facility delivery. There is also the need to improve maternal healthcare services utilization policies to promote access to health facility delivery by reducing costs and making health facilities available in communities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Ahinkorah

2020

BMC Health Serv Res

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“…Another possible reason for this finding is that although giving birth at health facility is free in Ghana, costs such as supplies and medications, transportation, unofficial provider fees may deter women who live in low-income settings. These are costs not covered under the current user-fee exemption policy and hence pregnant women may rather opt for TBAs, whose services are often cheap and considered negotiable [27].…”

Section: Discussionmentioning

confidence: 99%

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

Budu

2020

BMC Pregnancy Childbirth

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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.

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“…The available literature in Ghana has identified that women's choice of place for delivery is shaped by individual-level factors such as maternal age, education, religion, ANC utilization, and maternal knowledge [16][17][18]. However, the factors which influence women's choice of delivery place operate at various levels including household and community [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“I couldn’t buy the items so I didn’t go to deliver at the health facility” Home delivery among rural women in northern Ghana: A mixed-method analysis

et al. 2020

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Background Maternal mortality remains a major challenge to health systems in low and middle-incoming countries. Some pregnant women develop potentially life-threatening complications during childbirth. Therefore, home delivery is a precursor for maternal mortality. In this study, we aimed at not only estimating the percentage of deliveries occurring at home and examining the factors associated with home delivery, but we also explored the reasons for home delivery among women in rural Ghana. Methods The study was conducted among mothers with delivery experience in selected communities in the Builsa South district located in the Upper East Region of Ghana. Both quantitative and qualitative data were collected using semi-structured questionnaires and Focus Group Discussion (FGD) guide respectively. A total of 456 mothers participated in this study. Regression models were used in the quantitative analysis whereas a thematic analysis approach was used to analyze the qualitative data. Results Of the 423 mothers in the quantitative research, 38.1% (95% CI: 33.5-42.8) delivered their index child at home. In adjusted analysis, women who were not exposed to information (AOR = 13.64, p<0.001) and women with 2 (AOR = 4.64, p = 0.014), 3 (AOR = 4.96, p = 0.025) or at least 4 living children (AOR = 9.59, p = 0.001) had higher odds of delivering at home. From the qualitative analysis, the poor attitude of nurses (midwives), lack of, and cost

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

Cited by 24 publications

References 34 publications

Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

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

“I couldn’t buy the items so I didn’t go to deliver at the health facility” Home delivery among rural women in northern Ghana: A mixed-method analysis

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