Factors Contributing To Low Utilization Of Skilled Delivery In Ahafo Ano South District Ashanti Region, Ghana
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.
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.