Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women’s perceptions of skilled obstetric care
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Date
2015
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BioMed Central
Abstract
Background: Skilled birth attendance from a trained health professional during labour and delivery can prevent
up to 75 % of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical
infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through
analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access
to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in
a rural district of Ghana.
Methods: A cross-sectional survey was conducted from June to August 2012 in the Amansie West District of
Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were
used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression
analysis was used to identify factors associated with place of delivery.
Results: A total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth;
42.3 % of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery
were: insults from health workers (23.5 %), unavailability of transport (21.9 %), and confidence in traditional birth
attendants (17.9 %); only 7.4 % reported to have had sudden labour. Other factors associated with the use of
unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95 % CI; 0.01, 0.06),
lack of birth preparedness aOR = 0.05 (95 % CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery
aOR = 0.37 (95 % CI; 0.11, 1.20).
Conclusions: This study demonstrated the importance of provider-client relationship and cultural sensitivity in the
efforts to improve skilled obstetric care uptake among rural women in Ghana
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This article is published by BioMed Central.
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Citation
Nakua et al. BMC Pregnancy and Childbirth (2015) 15:243 DOI 10.1186/s12884-015-0674-1