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Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study

Author

Listed:
  • Yeetey Akpe Kwesi Enuameh
  • Sumiyo Okawa
  • Kwaku Poku Asante
  • Kimiyo Kikuchi
  • Emmanuel Mahama
  • Evelyn Ansah
  • Charlotte Tawiah
  • Kwame Adjei
  • Akira Shibanuma
  • Keiko Nanishi
  • Francis Yeji
  • Enoch Oti Agyekum
  • Junko Yasuoka
  • Margaret Gyapong
  • Abraham Rexford Oduro
  • Gloria Quansah Asare
  • Abraham Hodgson
  • Masamine Jimba
  • Seth Owusu-Agyei
  • Ghana EMBRACE Implementation Research Project Team

Abstract

Background: Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana. Methods: Data were collected from 1,500 women aged 15–49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models. Results: Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider’s influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96–30.48), place of residence (AOR = 4.49; 95% CI 1.14–17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29–2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43–5.60). Conclusion: In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider’s influence. Ensuring care provider’s counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana.

Suggested Citation

  • Yeetey Akpe Kwesi Enuameh & Sumiyo Okawa & Kwaku Poku Asante & Kimiyo Kikuchi & Emmanuel Mahama & Evelyn Ansah & Charlotte Tawiah & Kwame Adjei & Akira Shibanuma & Keiko Nanishi & Francis Yeji & Enoch, 2016. "Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-16, March.
    • Handle: RePEc:plo:pone00:0152235
    DOI: 10.1371/journal.pone.0152235
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    References listed on IDEAS

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    1. Jerome K Kabakyenga & Per-Olof Östergren & Eleanor Turyakira & Karen Odberg Pettersson, 2012. "Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-8, April.
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    Cited by:

    1. Cherri Zhang & Md Shafiur Rahman & Md Mizanur Rahman & Alfred E Yawson & Kenji Shibuya, 2019. "Trends and projections of universal health coverage indicators in Ghana, 1995-2030: A national and subnational study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-19, May.

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