Quality Of Maternal Health-Seeking Behaviour And Pregnancy Outcomes Among Young Women In Ghana

Abstract

Pregnancy among young women is a concern worldwide, especially in low- and middle-income countries i(LMICs), as they often have a higher incidence of adverse pregnancy outcomes. The utilization of maternal health care services is imperative to reducing the number of perinatal deaths and postnatal complications iamongst ipregnant iwomen. iAttempts ito iexplain ithis isituation ihave ifocusedioniindividual iandihouseholdilevel ideterminants, ibut itheiroleiofineighbourhoodifactors ihas inot ireceived imuch iattention. iUnderstanding ineighbourhood ifactors iassociated iwith imaternal ihealth-seeking ibehaviour iis iimportant. iThis iis ibecause iindividuals ireside iwithin ineighbourhoods iand itheir ihealth-related ibehaviour ican ibe iinfluenced iby ithe icharacteristics ior iconditions iof ithe ineighbourhoodiin iwhichitheyilive. This istudy iposits ithat iquality iof icare iand ineighbourhood-level icharacteristics iare ivery icritical ipredictors iof iyoung iwomen’s iutilization iof imaternal ihealth icare iand ipregnancy ioutcomes iamong iyoungiwomeniin iGhana, iin iadditionito iotheriindividual iandihouseholdicharacteristics. iDrawingion itheories iof ibehavioural imodel iof ihealthiservice iuse, ithe ithree idelays, iand iDonabedian’s iqualityiof icare imodel, ithe istudy iused ia imodified iBehavioural iModel iof iHealth iService iUse iand iQuality iof icareimodelitoiunderstandiindividualiandineighbourhood-level ifactorsionitheiutilizationiofimaternal ihealthcare iservices iandipregnancyioutcomes iamongiyoungiwomeniin iGhana. i Data ifrom ithe i2017 iGhana iMaternal iHealth iSurvey iwas iused ito iconduct ia iquantitative istudy ito iunderstand ithe ieffects iof iindividual iand ineighbourhood-level ifactors ion ithe iquality iof iantenatal icare, iskilled ibirth iattendance, iand ipregnancy ioutcomes. iThe iquantitative istudy iused ia isample iof i2,669 iyoung iwomen ibetween ithe iages iof i15 ito i24 iyears inested iwithin i900 iclusters iacross iGhana. iMultilevel ilogistic iregression imodels iwere iemployed ito iexamine ithe ieffects iof iindividual iand ineighbourhood-level ifactors ion ithe iquality iof iantenatal icare, iskilled ibirth iattendance, iand ipregnancy ioutcomes. iThe iquantitative ianalysis irevealed iboth iindividual iand icommunity-level ifactors ias isignificant ipredictors iof imaternal ihealth ioutcomes iin iGhana. iFor iinstance, iwealthier iwomen iand ithose iwith ihigher ieducation iwere isignificantly imore ilikely ito iutilize ithe iquality iof iantenatal icare iand idelivery iservices. i The ianalysis ialso irevealed ithat iafter icontrolling ifor iother ifactors, iplace iof iresidence, ia ineighbourhood ivariable ihas ino idirect iassociation iwith ithe iquality iof iANC, ihowever, iit ihas ia idirect icontribution ito iskilled ibirth iattendance iand ipregnancy ioutcomes. iNeighbourhood-level irandom ieffects iwere ialso isignificant iand ithere iwas iconfirmation iof inesting iat ithe ineighbourhood ilevel ieven iafter icontrolling ifor iindividual iand ineighbourhood-level ivariables. This istudy iprovides ifurther iempirical ievidence ithat, ito iimprove ithe istrides itowards ireducing ithe irisk iof iadverse ipregnancy ioutcomes iamong iwomen iin iGhana, iinterventions ishould ibe itargeted iat iwomen iin ipoor ihouseholds iliving iin ipoor isocioeconomic iconditions iwith ino iaccess ito iquality imaternal icare iservices. iThis iwould ihave ia isignificant iinfluence ion ithe iliving iconditions iof ithe iwomen iand ithus, ireduce itheir irisk iof ihaving ia inegative ioutcome iof ipregnancy.