Health Facility Delivery and Associated Factors in the Chereponi District of Northern Ghana

Abstract

Worldwide facility delivery remains a serious concern and challenge to all international, national and local stakeholders. It is important to reduce this burden of large number of women and neonates who die annually from preventable causes as a result of home delivery. Facility delivery is a critical strategy to improve maternal and newborn health inthe world, but still a large number of home deliveries occur in the developing countries, mostly in the Sub Sahara African countries. A quantitative cross-sectional study was conducted among women who delivered from March, 2017 to March, 2018 in Chereponidistrict. Structured questionnaire was administered to the mothers and data collected on factors likely to influence place of delivery. The study was conducted among women aged between 15 to 49 years who delivered within one year prior to the beginning ofthe study. Data on individual demographic characteristics, community level factors, institutional level factors and the level of facility delivery were collected from the respondents. Data wereanalyzed usingSTATA Version 15.0. Multivariate logistics regression was used to identifyfactors related to place of delivery, controlling for covariates that were statistically significant in the univariate regression model. Among440 women interviewed, 38.41% delivered at a health facility, while 61.59% deliveries took place at home.Several factors were identified to be significantly associated with place of delivery. These included: the women’s level of education (aOR=0.49, 95% CI: 0.07-53.63, P=0.013), her ethnicity (aOR=2.48, 95% CI: 0.51-11.92, P=0.003), income level (aOR=2.79 95% CI: 1.49-5.24, P=0.001), number of antenatal visits (aOR=2.41, 95% CI: 0.68-8.54, P=0.019), her husband’s level of education (P=0.001), distance to a health facility (aOR=0.51 95% CI: 0.31-0.85, P=0.003), health staff attitude (aOR=5.59, 95% CI: 2.11-14.82, P<0.001), and religion (P<0.001). High illiteracy rate, low income level of women, distance and staff attitude were the key factors explaining why rural women deliver at home. Addressing universal formal education, geographic access to health facilities and staff attitude will increase number of facility deliveries.