Home Birth without Skilled Attendants Despite Millennium Villages Project Intervention in Ghana: Insight from a Survey of Women’s Perceptions of Skilled Obstetric Care

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.

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.

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, lack of birth preparedness and lack of knowledge of the benefits of skilled delivery.

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.

Below:  Proportion of unskilled and skilled deliveries by sub-district at Amansie West, Ghana

Full article at: http://goo.gl/dn1NYr

By: 

Emmanuel Kweku Nakua^1*, Justice Thomas Sevugu¹⁴, Veronica Millicent Dzomeku³,Easmon Otupiri¹, Heather R. Lipkovich² and Ellis Owusu-Dabo⁵⁶

¹School of Public Health, Department of Population, Family and Reproductive Health, Kwame Nkrumah University Science and Technology, PMB, Kumasi, Ghana

²Henry Ford Health System, Department of Public Health Sciences, Detroit, MI, USA

³Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

⁴Sekyere-Kumawu Health Directorate, Kumasi, Ghana

⁵School of Public Health, Department of International and Global Health, KNUST, Kumasi, Ghana

⁶Kumasi Collaborative Center for Tropical Research, Kumasi, Ghana

  

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