Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana

Robert Kaba Alhassan (Lead / Corresponding author), Seth Owusu-Agyei, Evelyn Korkor Ansah, Margaret Gyapong, Anthony Ashinyo, Mary Eyram Ashinyo, Edward Nketiah-Amponsah, Edem Akorli-Adzimah, Edith Ekpor

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Sustainable Development Goal 3 aims at reducing global neonatal mortality to at least 12 per 1000 livebirths, under-five mortality to at least 25 per 1000 livebirths and maternal mortality ratio to less than 70 per 100,000 livebirths by 2030. Considering the achievement so far, many countries in sub-Saharan Africa, including Ghana are not likely to achieve these targets. Low utilization of maternal, newborn and child health (MNCH) services partly account for this predicament. This study explored the trend and correlates of MNCH services utilization in one administrative district in the Volta Region of Ghana.
Methods
This is an explorative ecological study employing trend analysis of 2015–2017 data from Ghana Health Service District Health Information Management System II. Univariate Poisson regression models were used to determine the factors associated with MNCH services utilization at 95% confidence level.
Results
Cumulative record of 17,052 antenatal care (ANC) attendance and 2162 facility-based spontaneous vaginal deliveries (SVDs) was discovered. Compelling evidence of potential unskilled deliveries was observed in 23% of the 26 facilities reported in the DHIMSII data. High cumulative number of midwives in health facilities associated positively with high records of ANC visits (IRR = 1.30, [95% CI:1.29, 1.32]; p = 0.0001), facility-based SVDs (IRR = 1.30 [95% CI:1.25, 1.35]; p = 0.0001) and BCG immunizations (IRR = 1.32 [95% CI:1.29, 1.34]; p = 0.0001). Likewise, high records of ANC visits correlated positively with high facility-based SVDs and child immunizations records (p < 0.0001).
Conclusion
Targeted health system and community level interventions alongside progressive frontline health staff motivation and retention strategies could further enhance enrollment and retention of mothers in pre-natal and postnatal care services throughout the continuum of care to guarantee better MNCH health outcomes. Investments in universal coverage for quality ANC services has the potential to enhance utilization of supervised deliveries and post-natal care services such as immunizations.
Original languageEnglish
Article number543
Number of pages15
JournalBMC Pregnancy and Childbirth
Volume20
Early online date17 Sept 2020
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Continuum of care
  • District health information management system II
  • Facility-based spontaneous vaginal deliveries
  • Maternal
  • Newborn and child health
  • Child immunizations
  • Utilization
  • Primary healthcare
  • Antenatal care
  • Health policy
  • Ghana

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