Factors Influencing Utilization of Skilled Delivery Services In Fanteakwa District, Eastern Region

Abstract

Background: Low utilization of skilled delivery claims the lives of about half a million of women globally each year and more than half of these deaths occur in Africa. Meanwhile, skilled delivery has been demonstrated to decrease maternal mortality and morbidity, yet in 2016 only 56. 2 % of women gave birth with the assistance of skilled birth attendants in Ghana. Objectives: The study assessed factors influencing utilisation of skilled delivery services in the Fanteakwa District, Eastern Region. Methods: A community based cross-sectional study was conducted. A sample of three hundred and fifty six (356 ) mothers were selected from eight (8) communities within four (4) sub- districts using a multi-stage sampling technique to select nursing mothers who delivered between January – December, 2017. Using structured questionnaire as a survey instrument, information sought included socio-demographic characteristics, client factors, healthcare provider factors, and community factors. The data were entered into Microsoft excel and imported to Stata version 15.0 for analysis; bivariate analysis and logistic regression analysis. The result of the study were obtained by processing data into frequency tables, chi-square values and regression models. A level of significance was accepted at p<0.05. Results: Out the 356 mothers, 66.9% used skilled delivery. Majority (51.4%) of the respondents were between 26 and 35 years of age. Variables that were significantly associated with utilisation of skilled delivery included level of education (p < 0.001), ANC visits (p < 0.001), parity (p < 0.001), quality of ANC counselling (p < 0.026) , road network (p<0.004) and the means of health access during emergency (p <0.030). Predictors of utilisation of skilled delivery were good quality of counseling (OR 2.498 CI: 1.261 - 4.945), more than four ANC visits (AOR 12.971 CI: 4.489 – 37.481), having less than 5 children (AOR: 3.277 CI: 1.691 – 6.350) and very accessible road network (AOR 5.327 CI: 1.739 - 16.317). Conclusions/Recommendations: The study revealed that, 69.9% of respondents used skilled delivery services. Educational level of the women, quality of counselling, number of ANC visits, parity, road network and means of transportation to access health services during emergencies were the major factors identified to have influenced skilled delivery services in the Fanteakwa District. Hence it is recommended that education must be embarked upon by health care providers on birth preparedness. The ministry of education should ensure that women have at least basic level of education.