Utilization of maternal health services in the Bosomtwe Atwima Kwanwoma District, Ashanti Region, Ghana

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Pregnancy related complications are the leading cause of death among women in the reproductive ages 15-49 years in developing countries. Despite the interventions instituted globally to reduce this menace, maternal mortality is still high in the developing countries. Research has shown that adequate use of antenatal and delivery services can reduce maternal deaths between 10% to 45%, especially in the developing countries. The objective of this study is to assess factors responsible for the decreasing trend in ANC attendance and delivery services as well as low utilization of family planning services in the Bosomtwe Atwima Kwanwoma (BAK) district in order to come out with recommendations to improve the maternal health services utilization. A descriptive cross-sectional study was carried out in 3 out of the 5 sub-districts in BAK namely Kuntanase, Amakom and Trede. They were selected by simple random sampling. A multistage cluster sampling was employed to identify the respondents’ household. In all 18 clusters of communities were selected and a total of 180 women within the age group of 15-45 years who had delivered at least once within the five years preceding the study were interviewed through interview guide and focus group discussions. The modal age class was 30-34 years (26.7%) with 19.4% uneducated. 80.6% of respondents earned monthly income of less than two hundred thousand cedis with unemployed being 6.7%. 53.3% claimed their husbands decided on the place of delivery. 92 (51 .1 %) lived less than 5km away from health facilities and 50% walked to health care facilities. 7.2% preferred to deliver at home and 56.1% preferred to deliver at public health care facilities. 11.7% were using some modern family planning method. 57.2% attended ANC more than 4 times. About 80% of respondents were satisfied with service delivery. The study also revealed other factors which accounted for the downward trend in utilization, such as the influence on women by the family members and delay in reporting to health facility when in labour. It is recommended to the Ministry of Health that, health education on the benefits of ANC and delivery at public health care facilities should be intensified. Also there is a need to disabuse the minds of both men and women about the erroneous impression and the false beliefs on family planning services.
A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of MSc.degree in Health Services Planning and Management, 2004