Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in Northern Ghana

BMC Public Health

Samuel Mills⁵  Kojo Yeboah-Antwi⁴  Judith Bernstein¹  Lois McCloskey¹  Henry V Doctor²  Evelyn Sakeah³ 

[1] Community Sciences Department, Boston University School of Public Health, Boston, MA, USA;Integrated Programme and Oversight Branch, Division for Operations, United Nations Office on Drugs and Crime, Abuja, Nigeria;Social Science Unit, Navrongo Health Research Centre, Upper East Region, Navrongo, Ghana;International Health Department, Boston University School of Public Health, Boston, MA, USA;Health, Nutrition, and Population, Human Development Network, The World Bank, Washington DC, USA

关键词: Skilled attendants at birth;    Women service utilization;    Maternal mortality;    Ghana;    Community-based service delivery;   

Others  :  1131577
DOI  :  10.1186/1471-2458-14-344

 received in 2013-09-10, accepted in 2014-03-28,  发布年份 2014

【 摘 要 】

Background

The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women.

Methods

We conducted a cross-sectional household survey with women who had ever given birth in the three years prior to the survey. We employed a two stage sampling techniques: In the first stage we proportionally selected enumeration areas, and the second stage involved random selection of households. In each household, where there is more than one woman with a child within the age limit, we interviewed the woman with the youngest child. We collected data on awareness of the program, use of the services and factors that are associated with skilled attendants at birth.

Results

A total of 407 households/women were interviewed. Eighty three percent of respondents knew that CHO-midwives provided delivery services in CHPS zones. Seventy nine percent of the deliveries were with skilled attendants; and over half of these skilled births (42% of total) were by CHO-midwives. Multivariate analyses showed that women of the Nankana ethnic group and those with uneducated husbands were less likely to access skilled attendants at birth in rural settings.

Conclusions

The implementation of the CHO-midwife program in UER appeared to have contributed to expanded skilled delivery care access and utilization for rural women. However, women of the Nankana ethnic group and uneducated men must be targeted with health education to improve women utilizing skilled delivery services in rural communities of the region.

【 授权许可】

   
2014 Sakeah et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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