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Use of Health Professionals for Delivery Following the Availability of Free Obstetric Care in Northern Ghana

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dc.contributor.authorMills, S.
dc.contributor.authorWilliams, J. E.
dc.contributor.authorAdjuik, M.
dc.contributor.authorHodgson, A.
dc.date.accessioned2012-03-30T07:31:20Z
dc.date.available2012-03-30T07:31:20Z
dc.date.issued2008
dc.description.abstractOBJECTIVES: To assess the factors associated with the use of health professionals for delivery following the implementation of a free obstetric care policy in the poorest regions of Ghana. METHODS: All 4,070 women identified in the Navrongo demographic surveillance system with pregnancy outcomes in the Kassena-Nankana district between January 1 and December 31, 2004 were eligible for the study. Three thousand four hundred and thirty three women completed interviews on socio-demographic and pregnancy related factors. Information on 259 communities including travel distance to the nearest health facility was also obtained. Multilevel logistic regression analyses were conducted. RESULTS: ninety eight percent of women received antenatal care but only 38% delivered with the assistance of health professionals. In a multilevel logistic model, physical access factors {such as availability of public transport, odds ratio (OR) = 1.50 (1.15-1.94), travel distance to the district hospital [for 20+ km, OR = 0.31 (0.23-0.43)] as well as community perception of access to the nearest health facility [for highest quintile, OR = 4.44 (2.88-6.84)]} showed statistically significant associations with use of health professionals at last delivery. Women who knew that delivery care was free of charge were 4.6 times more likely to use health professionals. Higher parity was strongly negatively associated with use of health professionals [OR = 0.37 (0.29-0.48) for parity > or = 4 compared to parity 0-1]. However, community perception of quality of care was not associated with use of health professionals for delivery. CONCLUSION: Physical access factors remain strong determinants of use of professional delivery care in rural northern Ghana.en
dc.identifier.citationMatern Child Health J
dc.identifier.issn1092-7875 (Print) 1092-7875 (Linking)
dc.identifier.urihttps://hdl.handle.net/10986/5110
dc.language.isoEN
dc.relation.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/igo
dc.rights.holderWorld Bank
dc.subjectAdult
dc.subjectCross-Sectional Studies
dc.subjectObstetric Delivery
dc.subjectFemale
dc.subjectGhana
dc.subjectHealth Services Accessibility
dc.subjectHumans
dc.subjectInterviews as Topic
dc.subjectMaternal Health Services
dc.subjectNational Health Programs
dc.subjectPatient Acceptance of Health Care
dc.subjectPoverty Areas
dc.subjectPregnancy
dc.subjectTravel
dc.subjectYoung Adult
dc.titleUse of Health Professionals for Delivery Following the Availability of Free Obstetric Care in Northern Ghanaen
dc.title.alternativeMatern Child Health Jen
dc.typeJournal Articleen
dc.typeArticle de journalfr
dc.typeArtículo de revistaes
dspace.entity.typePublication
okr.doctypeJournal Article
okr.externalcontentExternal Content
okr.identifier.doi10.1007/s10995-007-0288-y
okr.identifier.externaldocumentum1812
okr.identifier.internaldocumentum17955355
okr.journal.nbpages509-18
okr.language.supporteden
okr.peerreviewAcademic Peer Review
okr.region.countryGhana
okr.relation.associatedurlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17955355
okr.volume12
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