Factors associated with optimal antenatal care use in Northern region, Ghana

ABSTRACT

The objective of this study was to investigate the factors associated with the optimal use of antenatal care (ANC) during pregnancy. A facility-based cross-sectional survey was conducted between February and August 2014 among nursing mothers (n = 578) attending postnatal and child welfare clinics in three districts in Northern Ghana, representing urban, peri-urban, and rural zones. The developed questionnaire aided the collection of information on maternal demographic characteristics, health status, household assets, and ANC attendance. Binary logistic regression was modeled to estimate the association between optimal ANC use and mothers’ characteristics. Approximately 81% of the respondents had ≥4 ANC visits during pregnancy, and coverage was over 99%. Mothers who had any formal education (adjusted odds ratio [AOR] = 1.7, 95% confidence interval [CI] = 1.0–2.8, P = 0.040) lived in middle class socioeconomic households (AOR = 2.6, 95%CI = 1.4–4.8, P = 0.003) and resided in urban areas (AOR = 2.0, 95%CI = 1.2–3.3, P = 0.006) were significantly more likely to report the optimal ANC use. Mothers’ education, socioeconomic status, and proximity to a health facility were positively associated with the optimal ANC use. Education of females and policy initiatives aimed at improving the rural–urban divide are essential to optimize the use of ANC.

KEYWORDS:

• Antenatal care
• pregnancy
• socioeconomic
• Northern Ghana

Implications for practice and policy

To facilitate current progress toward universal ANC coverage in Ghana, deliberate policy interventions targeted at reducing poverty and improving access to health facilities within rural settings, promoting maternal and girl child education, and improving the general livelihood and socioeconomic conditions of the poor are recommended. These have the potential of empowering women particularly those in deprived areas to cultivate health seeking habits that would lead to the optimal use of ANC, and eventually mitigate maternal and child mortality.

Acknowledgments

We express our gratitude to all the managers of the Hospitals where the data collection took place, particularly, the Head of Obstetric and Gynecology Department of Tamale Teaching Hospital and all the midwives in charge of the labor and maternity wards of Tamale Teaching, Tamale Central, Tamale West, and Savelugu District Hospitals. We also thank the nutrition officers of the above hospitals for their immense support during the data collection. This work would not have been possible without the support of the Dean of School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana.