Factors Influencing Skilled Delivery in the Asante Akim North Municipality of Ghana.

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Childbirth is important to human existence. Complications during childbirth can lead to death or disability of a mother or a child. Maternal mortality is estimated to be over 440,000 per 1000 live births and the highest which is 99.0% is in the developing countries (WHO 2004). The risk of maternal death is about 175 times greater in some parts of the developing world than in the industrialized countries. (Hill et al., 2001). In the more developed countries, skilled attendance have reached 99.5%, on the other hand, 46.5% and 65.4%, of women gave birth with professional assistance in Africa and Asia respectively (2008 Updates Proportion of birth attended by skilled attendant – WHO). In Ghana, skilled delivery remain stagnant around 47.1%, which is 37.9% away from WHO’s target for 2010, which estimates that by 2010, 90.0% all births should be attended by skilled attendants. The Asante-Akim North municipality recorded an increase of 58.8% of skilled attendance in 2006 from that of 53.4% in 2005. The fact is that the municipal area is still below the target set by WHO. The main objective of the study was to assess the factors influencing skilled delivery in Asante Akim North Municipal. The study was a cross-sectional non-experimental descriptive design. Data was collected using questionnaires. Simple random sampling and convenience sampling were both employed in the selection of participants to the study. Statistical tool used for the analysis of the data collected for the study was SPSS version 15.0. Majority of respondents were aged 36 years and above with a few below that age. Most of the respondents had basic education with a few obtaining certificates above the secondary/vocational levels of education and some with no formal education. Respondents who had 2-4 children were more than those with 5 or more children. Majority of the respondents were Christians (95.7%). Moslems (2.9%) formed just a few of the respondents. Some of the respondents lived with partners who they are not legally married to, whilst others, a minority, were single, divorced and widowed. Employment status of respondents ranged from civil services, to traders, farmers and tradesmen, a few of them were unemployed. More than half of the respondents (71.2%) had membership status with the health insurance scheme. Married respondents, farmers and the unemployed formed the majority groups of those who did not use the skilled attendants. Half of non-members of the health insurance scheme were among those who used unskilled delivery services. More than half of the respondents claimed they visited ANC. Over eighty percent of those who used unskilled delivery visited ANC during pregnancy. Respondents who were told to prepare for their delivery were significantly influenced to use skilled attendants. Majority of respondents (95.1%) indicated from the data that they were aware of the importance of the skilled delivery services; however, they were not influenced enough by this knowledge to make use of skilled attendants during delivery. The study recommended the sensitization of the following members of the society: married respondents, farmers and the unemployed, on the need to use health facility during delivery and be attended to by a professional midwife to help prevent maternal and infant mortality.
A Thesis Submitted to the Department of Community Health,Kwame Nkrumah University of Science and Technology in Partial Fulfilment of the Requirements for the Degree of MASTER OF SCIENCE in Health Education and Promotion,