Factors Associated With The Uptake Of Antenatal Care Services Among Women Of Sefwi Akontombra District In The Western North Region Of Ghana
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Date
2020-12
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University Of Ghana
Abstract
This study aimed at ascertaining the factors associated with the uptake of antenatal care services in the Sefwi Akontombra District of the Western North Region of Ghana. It was necessary to carry out this study because there is low attendance of antenatal care (54.1%) albeit the district's target of 80% based on the minimum attendance of 4 visits. The existing report showed that only 30.7% of the women who registered for antenatal care services (ANC) fully met the criterion of 4 ANC visits (Sefwi Akontombra health directorate annual report, 2016).
This study used a quantitative facility-based descriptive cross-sectional design. Four hundred and twenty (420) women in fertile age (WIFA), 15-49 years who have given birth within the past two years and were attending child welfare clinic (CWC) during the data collection period were involved. A systematic sampling method was used to select eligible women at each child welfare clinic after estimating the sample size for each sub – district and facility using a sample proportional to the population. Structured questionnaires were interviewer-administered to respondents and data were entered into statistical software Stata version 15 for analysis. Descriptive statistics such as frequencies and percentages were determined for respondents' characteristics and presented in tables and graphs. Also, logistics regression analysis reporting odds ratios was performed to determine factors that influence the uptake of antenatal services among respondents. A p-value of < 0.05 was considered statistically significant.
Results from the study show that uptake of ANC services in Sefwi Akontombra District is low with only (20.7%) of respondents meeting the recommended ANC visits of at least 8. About 3-in-4 of the women had average knowledge about ANC services.
The intensity of ANC utilization increases with age. Women aged 35 and above had six times the odds (AOR: 6.33, 95% CI: 1.98-20.31; p=0.002) of making a minimum of 8 visits compared to women in lower age groups. The uptake of ANC services was negatively associated with education and trimester of first ANC visit. Women with no formal education had five times the odds of utilizing ANC services compared to those with tertiary education (AOR: 5.32, 95% CI: 1.06-26.58; p=0.042). Similarly, women who had their first ANC visit in their third trimester had four times the odds (AOR: 4.49, 95% CI: 1.07-18.83; p=0.040) of utilizing ANC services compared to their counterparts who had their first ANC visit in their first trimester. Also, women who perceive the overall ANC service charges to be affordable and free had increased odds of utilizing the services (AOR: 1.93, 95% CI:1.02 – 3.67; p=0.044) and ( AOR: 2.69, 95% CI: 1.21 – 5.94; p=0.015) respectively.
Despite the high investment in maternal health, inadequate uptake of ANC services remains a problem in the Sefwi Akontombra district. This may be attributed to the perceived high cost of indirect service charges, the strong desire of some women to deliver outside the health facilities, and the unattractiveness of ANC services to most adolescents due to stigmatization and ridicule at service centers.
More innovative ways of providing health education may be needed to improve women's knowledge of the importance of ANC services. The free maternal health policy should be reviewed and enforced to cover all services offered at antenatal care. Finally, there is a need to introduce adolescent-friendly maternal services to make the utilization of ANC services attractive to adolescents and younger adults who are pregnant.
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Keywords
Antenatal Care Services, Sefwi Akontombra, Western North Region, Women