Factors Contributing To Low Utilization Of Skilled Delivery In Ahafo Ano South District Ashanti Region, Ghana
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Date
2008-07-12
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Abstract
This was a cross-sectional design to examine the factors affecting utilisation of skilled attendants among
women in Ahafo-Ano South district in Ashanti. Using a systematic sampling method, a total of 312 women
were interviewed using interview guide in six communities in the district. In addition, six health workers
were interviewed and also 10 antenatal clinic sessions were observed. The objective of the study was to
assess the quality of prenatal services; estimate the extent of access to skilled delivery and identify potential
barriers; assess the districts capacity in providing skilled delivery services; and to identify the socioeconomic
and cultural barriers to utilization of skilled delivery services.
The results showed that thirty seven percent (37%) of the women delivered outside a health facility. Health
workers interaction with pregnant women was satisfactory however, most (75%) of the public health
facilities lacked delivery beds. The barriers to use of skilled attendants among the women include: lack of
access road (Chi- = 18.10 p=0.00); lack of vehicles (chi= 14.00, p=0.00); and perceived cost of transport
(chi = 3.63 p=0.05). Women who used tarred roads to the nearest health facilities were three times (OR =
2.98) more likely to use skilled attendants, and fourteen times (OR = 13.61) than those who lived on farm
paths (inaccessible road). Women who have access to vehicles to the nearest health facility are five times
(OR = 4.60) more likely to use skilled attendants compared to those who use trucks. Socio-economically,
educated women were three times (chi = 29.24, p = 0.00; OR = 3.15) more likely to use skilled attendant,
also women with educated husbands were two times (chi = 8.09, p = 0.00; OR = 2.15) more likely to use
skilled attendants than those without educated husband. The employment of the women or their partners did
not influence the use of skilled attendants (chi = 0.20; p = 0.65)
It is concluded that inaccessible roads to health facilities; lack of access to vehicles; low education of
women and their husband; and inadequate equipment (delivery beds) at the health facilities accounts for the
low utilization of skilled attendants in the Ahafo-Ano South district. It is recommended that the District
Assembly, District Health Directorate and Opinion Leaders should collaborate to provide the feeder roads
to link communities to the nearest health centre and also intensify education on the use of such services.
Description
Thesis Submitted To The School Of Graduate Studies, Kwame
Nkrumah University Of Science And Technology, Kumasi, In
Partial Fulfilment Of Requirement For The Award Of Degree
In Master Of Public Health
(Population And Reproductive Health)
Mabel Nai- Adjei
November.