Factors Influencing Antenatal Care Service Utilization In Sekondi- Takoradi Metropolis, Western Region, Ghana.

Abstract

Background: Antenatal Care (ANC) is a category of preventive healthcare services aiming to provide regular check-ups that permit health care professionals especially midwives and doctors to prevent and treat potential health problems during the pregnancy period as well as promoting healthy lifestyles to ensure their safety. Poor utilization of ANC services could lead to poor pregnancy outcomes that can affect achieving the Sustainable Development Goals (SDG) targets of reduced maternal and neonatal morbidity and mortality by the year 2030. This study therefore examined ANC services utilization and factors influencing its utilization in the Sekondi-Takoradi Metropolis in both public and private health facilities at the urban and rural settlements. Methods: A cross-sectional study design with mixed methods (quantitative and qualitative) approach was employed to carry out this stud) . The study was conducted at Post -natal units of selected public and private health facilities in Sekondi-Takoradi Metropolis in the Western Region from April to May 2019. An interviewer-administered structured questionnaire was administered and data collected on clients' socio-demographic factors , heath facility and community related factors which could influence ANC service utilization. In-depth interviews were also conducted among midwives . Using an interview guide t\~ o focus group discussions (one male, one female) were conducted in the communities in which tile selected heath facilities were located . Data was analyzed descriptively. Chi-square test was us1,;d to determine associations between independent variables and the outcome variable. Results was presented as frequencies and proportions in tables and graphs with Odds ratio as measure of associations at 95% confidence intervals with p-value < 0.05. In the multivariate analysis, Mothers who lived in urban areas had 3. 5 times (95% CI: 1.1-11 .4) odds of ANC services utilization compared to those who lived in rural areas and this association was also statistically significant. Jn addition, mothers' who were married had 3.2 folds (95% CI: 1.22- 8.44) odds of ANC services utilization compared to those who were single. Likewise, mothers who were cohabiting also had a 14.05 times (95% CI: 2.95-65.87) odds more of ANC services utilization compared to those who were single. Again this association was statistically significant. Mothers who were employed had 4.5 folds (95% CI: 1.4-14.3) odds of ANC services utilization compared to those who were unemployed. Primiparous mothers had 5.0 folds (95% CI: 2.6-9.7) odds of ANC services utilization compared to multiparous mothers and this association was statistically significant. Mothers with good level of knowledge on benefits of ANC services, had 20.5 folds (95% CI: 7 .6-55 .1) odds of utiIization of prenatal services as opposed to those with poor knowledge and this association was statistical I· significant. Conclusions: ANC service utilization is largely under-utilized in Sekondi-Takoradi Metropolis. Knowledge on benefits of prenatal services and awareness of the required minimum four ANC visits for pregnant women without any complications in their pregnancies were low. In addition, there were additional payments by NHIS holders who went to access services from the various health facilities in the districts. Major preventive measure is to increase public awareness on the benefits of prenatal services utilization in STM and to strengthen the usage of NHJS.