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Rural/Urban and Socioeconomic Differentials in Quality of Antenatal Care in Ghana

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  • Patience A Afulani

Abstract

Background: Approximately 800 women die of pregnancy-related complications every day. Over half of these deaths occur in sub-Saharan Africa (SSA). Most maternal deaths can be prevented with high quality maternal health services. It is well established that use of maternal health services vary by place of residence and socioeconomic status (SES), but few studies have examined the determinants of quality of maternal health services in SSA. The purpose of this study is to examine the determinants of antenatal care (ANC) quality in Ghana–focusing on the role of place of residence and SES (education and wealth). The analysis also examines the interactions of these variables and the mediating role of ANC timing, frequency, facility type, and provider type. Methods: The data are from the Ghana Maternal Health Survey (N = 4,868). Analytic techniques include multilevel linear regression with mediation and moderation analysis. Results: Urban residence and higher SES are positively associated with higher ANC quality, but the urban effect is completely explained by sociodemographic factors. Specifically, about half of the urban effect is explained by education and wealth alone, with other variables accounting for the remainder. The effects of education are conditional on wealth and are strongest for poor women. Starting ANC visits early and attending the recommended four visits as well as receiving ANC from a higher level facility and from a skilled provider are associated with higher quality ANC. These factors partially explain the SES differentials. Implications: Ghanaian women experience significant disparities in quality of ANC, with poor illiterate women receiving the worst care. Targeted efforts to increase quality of ANC may significantly reduce maternal health disparities in Ghana and SSA. A particularly crucial step is to improve ANC quality in the lower level health facilities, where the most vulnerable women are more likely to seek ANC.

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  • Patience A Afulani, 2015. "Rural/Urban and Socioeconomic Differentials in Quality of Antenatal Care in Ghana," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-28, February.
    • Handle: RePEc:plo:pone00:0117996
    DOI: 10.1371/journal.pone.0117996
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    1. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    2. Andersen, Helle Max, 2004. ""Villagers": Differential treatment in a Ghanaian hospital," Social Science & Medicine, Elsevier, vol. 59(10), pages 2003-2012, November.
    3. Sanjay Basu & Jason Andrews & Sandeep Kishore & Rajesh Panjabi & David Stuckler, 2012. "Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 9(6), pages 1-14, June.
    4. Roger A. Atinga & Anita A. Baku, 2013. "Determinants of antenatal care quality in Ghana," International Journal of Social Economics, Emerald Group Publishing, vol. 40(11), pages 852-865, August.
    5. Adjiwanou, Vissého & LeGrand, Thomas, 2013. "Does antenatal care matter in the use of skilled birth attendance in rural Africa: A multi-country analysis," Social Science & Medicine, Elsevier, vol. 86(C), pages 26-34.
    6. Wendy J Graham & Affette McCaw-Binns & Stephen Munjanja, 2013. "Translating Coverage Gains into Health Gains for All Women and Children: The Quality Care Opportunity," PLOS Medicine, Public Library of Science, vol. 10(1), pages 1-3, January.
    7. Stanislav Kolenikov & Gustavo Angeles, 2009. "Socioeconomic Status Measurement With Discrete Proxy Variables: Is Principal Component Analysis A Reliable Answer?," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 55(1), pages 128-165, March.
    8. WHO & UNICEF & UNFPA & World Bank & United Nations Population Division, 2014. "Trends in Maternal Mortality : 1990 to 2013," World Bank Publications - Books, The World Bank Group, number 18203, December.
    9. Duong, Dat V & Binns, Colin W & Lee, Andy H, 2004. "Utilization of delivery services at the primary health care level in rural Vietnam," Social Science & Medicine, Elsevier, vol. 59(12), pages 2585-2595, December.
    10. Roger A. Atinga & Anita A. Baku, 2013. "Determinants of antenatal care quality in Ghana," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 40(10), pages 852-865, August.
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