Factors Influencing Utilisation of Skilled Delivery in the East Akim Municipality of Ghana

Abstract

Background: Even though skilled birth attendance is useful for reducing maternal mortalities and morbidities, utilisation of skilled delivery in Ghana is sub-optimal. The main purpose of this study is to identify the factors that influence the utilisation of skilled delivery in the East Akim District of the Eastern region, Ghana. Methods: A facility-based cross-sectional study employing quantitative research methods was carried out among 352 postnatal women attending child welfare clinics at the Kibi Government Hospital, New Tafo Government Hospital, Asiakwa Health Centre and Apedwa Health Centre, East Akim District in the Eastern region, Ghana. A consecutive sampling technique was used in selecting eligible participants. Data were collected on socioeconomic and demographic factors, health service factors and relevant reproductive history. The data were cleaned and entered into STATA software (version 15). Chi-square test was performed to test the associations between independent variables (demographic factors, health service factors and relevant reproductive history) and the dependent variable, utilisation of skilled delivery. Simple and multiple binary logistic regressions were carried out to determine the factors that are associated with the utilisation of skilled delivery. Statistical significance was determined at p-value < 0.05. Results: The results of this study show that the estimated proportion of women who used skilled delivery was 85.2%. The majority (44.3%) of the participants were married and 69.9 % had attained primary/JHS/Middle school. More than three-quarters of respondents were employed with 67.6% engaged in artisanal services such as hairdressing, dressmaking, and catering. The majority (92.9 %) professed the Christian faith. The results showed that 57.9 % of respondents earned an average monthly income below GH¢250.00. History of obstetric complication, availability of equipment with medication for treatment and age of pregnancy at first ANC contact were significantly associated with skilled birth delivery in bivariate regression analysis. After adjusting for socio-economic and demographic factors, women with no history of obstetric complication had lower odds of utilizing skilled delivery (aOR = 0.04, 95%: 0.008 – 0.2, p-value = <0.001). Women who said that the facilities that they attended were equipped or highly equipped had higher odds of utilising skilled birth delivery [(aOR = 14.6, 95%CI: 2.03 – 104.2, p-value =0.008) and (aOR = 41.7, 95% CI: 5.1 – 342, p-value = 0.001) respectively. Conclusion: This study reports a high utilisation of skilled delivery in the East Akim municipality. After adjusting for marital status, partner educational level, maternal employment, paternal employment, and average monthly income, history of obstetric complication and availability of equipment with medication for the treatment were significantly associated with skilled birth delivery.