Wealth and antenatal care use: implications for maternal health care utilisation in Ghana

Abstract

The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the rural areas and in some of the regions. The government and other service providers (NGOs, religious institutions and private providers) may endeavor to improve on the distribution of health facilities, human resources, good roads and necessary infrastructure among other things in order to facilitate easy access to health care providers especially for the rural dwellers.

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

“…However, we found that they were more likely to have attended ANC at least four times if they had enrolled in the health insurance scheme. Consistent with those of earlier studies [4,36,42–49], the findings of the current study demonstrated the importance of health insurance in seeking and receiving healthcare. Implementation of the Ghanaian government policy for free medical care for pregnant women under the NHIS could have been a factor in increasing ANC attendance.…”

“…The World Health Organization has advised pregnant women to attend ANC at least four times [3]. Appropriate use of ANC could significantly improve early identification and mitigation of risk factors in pregnancy [4]. In contrast, failure to attend ANC or inadequate ANC attendance could lead to complications, exacerbate pre-existing conditions, or worsen the consequences of an unhealthy lifestyle during pregnancy [5,6].…”

Factors Affecting Prenatal Care Utilization in East Wollega Zone, Oromia Regional State, Ethiopia

“…The effect was more significant among women with at least secondary school education. The data is consistent with studies from Ghana (Arthur, 2012), migrants in Western (Boerleider, et al, 2013), Brazil (Coimbra et al, 2007), Nigeria (Iyaniwura and Yussuf, 2009), Nepal (Joshi et al, 2014), Ethiopia (Tekelab and Berhanu, 2014). Thus, improving the education of mothers will contribute greatly to the use of maternal and prenatal services by women and thus help in reducing maternal and child mortality.…”

Unmet reproductive health care needs among rural Ghanaian women

“…Despite maternal and child friendly center campaigns, and the expansion of Communitybased Health Planning and Services (CHPS), many births remain unattended by skilled professional care. Many broader social determinants of health care are found to have a great impact on women maternity care utilization in poor settings (Arthur, 2012;Gayawan, 2013).…”

“…The need for a review of the development of contextspecific measures is highlighted and advocated in this research question of the dissertation. Stakeholders' views in Ghana on maternity care shortcomings cites poor obstetric care, informal payments, poor allocation of skilled providers and unfriendly health provider attitude as factors impeding service provision and utilization (Arthur, 2012;Atinga & Baku, 2013; Josephine Borghi et al, 2003;Perkins et al, 2009). Evidence from other studies show many barriers for maternity care seeking, which are related to providers, health system features and user characteristics (Addai, 1998;Asamoah et al, 2014;Atinga & Baku, 2013;Atunah-Jay et al, 2013; Josephine Borghi et al, 2003;Filippi et al, 2006;Ganle, 2014;Ganle et al, 2015;Lambon-Quayefio & Owoo, 2014;Perkins et al, 2009; Sophie Witter et al, 2007).…”