The Influence of Antenatal Care System on Ghanaian Women’s Preference of Public or Private Delivery Facility
Keywords:
antenatal care, health providers, public-private facility delivery, NHIS, GhanaAbstract
Comprehensive antenatal care is important for reducing maternal mortality in developing countries. The quality of care received during antenatal visits determines subsequent use of maternal healthcare, particularly for delivery. However, the choice between a private and public health facility for delivery varies in ways that are not completely understood, but is hypothesized to be influenced by the experiences of women during antenatal care. This study explores the influence of type of antenatal care provider on the final place of delivery – public or private – in Ghana. We analyzed the 2014 Ghana demographic and health survey data using univariate and multilevel logistic regression. The odds of delivering in a public health facility increased significantly from 1.56 in the first model to 1.661 for women who received antenatal care from a nurse/midwife. In the second model, women who received antenatal care from a physician were significantly less likely to use a public facility for delivery, while those who received service from a community health officer were over than three times more likely to deliver in a public facility. In the final model, the odds ratio of a woman who received care from a physician delivering in a public facility increased but decreased for a Community Health Officer after adjusting for geographic location and socioeconomic status variables. Discussion of the findings is provided in the body of the paper.
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