Department of Biological Sciences

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    Regional disparities and socio-demographic factors associated with eight or more antenatal care visits in Ghana
    (BioMed Central, 2024-10-28) Aboagye, Richard Gyan
    BACKGROUND: Antenatal care is vital for maternal health and wellbeing, with the World Health Organization recommending a minimum of eight visits during pregnancy. In this study, we examined the regional disparities and factors associated with eight or more antenatal care visits in Ghana. METHODS: We performed a cross-sectional analysis of data from the 2022 Ghana Demographic and Health Survey. Our study comprised 3,893 women of reproductive age with birth history in the last two years before the survey. Regional disparities in the proportion of eight or more antenatal care visits were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was conducted to determine the factors associated with eight or more antenatal care visits using a four-modeled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). RESULTS: The prevalence of eight or more antenatal care visits in Ghana was 38.4% \[95% CI = 36.0-41.0\]. The regions with the highest prevalence were Eastern, Greater Accra, Western, and Volta. Those with the lowest prevalence were Northern, North East, Savannah, and Oti. The odds of eight or more antenatal care visits were lower among women aged 40-49 \[aOR = 0.42, 95% CI = 0.18-0.96\], women with four or more children \[aOR = 0.57, 95% CI = 0.36-0.93\], women who wanted pregnancy later \[aOR = 0.63, 95% CI = 0.46-0.85\], and women in five regions: Western North \[aOR = 0.43, 95% CI = 0.19-0.94\], Bono \[aOR = 0.33, 95% CI = 0.14-0.76\], Northern \[aOR = 0.29, 95% CI = 0.13-0.66\], Savannah \[aOR = 0.30, 95% CI = 0.14-0.65\] and North East \[aOR = 0.33, 95% CI = 0.14-0.75\]. Women in the richer \[aOR = 1.99, 95% CI = 1.19-3.33\] and richest \[aOR = 4.82, 95% CI = 2.45-9.51\] wealth index showed a higher likelihood of completing eight or more antenatal care visits relative to women in the poorest wealth index. CONCLUSION: A significant proportion of women in Ghana fall short of the recommended eight or more antenatal care visits. Age, parity, desired pregnancy timing, wealth status, and region of residence are associated with the number of antenatal care visits. Women in five regions (Bono, Northern, North East, Savannah, and Western North) are significantly less likely to have eight or more antenatal care visits than those in the Western region. The government and policymakers should design programs to address the needs of older women, those with high parity, and women who want to delay pregnancy. Increased healthcare resources, educational campaigns, and addressing regional barriers to antenatal care access are crucial. Promoting public health initiatives to emphasise the importance of completing the recommended number of antenatal care visits for a healthy pregnancy is essential.
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    Utilisation of eight or more antenatal care visits and its associated socio-economic-related inequalities in sub-Saharan Africa: A decomposition analysis
    (Public Library of Science, 2025-03-25) Aboagye, Richard Gyan
    INTRODUCTION: Inadequate utilisation of maternal healthcare services, particularly antenatal care (ANC), poses a challenge in sub-Saharan Africa (SSA). There is a dearth of regional studies that address the socio-economic disparities in the use of ANC in SSA. Therefore, we examined the wealth and education-based inequalities in the utilisation of ANC services among women in SSA. METHODS: We analysed secondary data obtained from the Demographic Health Survey conducted in fifteen countries in SSA. We estimated the degree of wealth and education-related inequalities using concentration curves, concentration indices (CIX), and decomposition analysis, which identified the factors contributing to the disparities in the utilisation of ANC. All the analyses were conducted using Stata version 17.0 (Stata Corporation, College Station, TX, USA). RESULTS: The results revealed a significant socio-economic gap in utilising ANC in SSA. We found positive and statistically significant wealth index-related (CIX = 0.30; p-value < 0.0001) and education-based inequalities (CIX = 0.33; p-value < 0.0001) in eight or more ANC visits. The extent of wealth index-related and education-based inequalities varied across the fifteen countries. The decomposition analysis showed that educational attainment accounted for about 21% of the inequalities in eight or more ANC visits. Wealth index contributed 12.14% of the inequalities in eight or more ANC visits. Our results further showed that women's education, wealth, parity, and place of residence significantly contributed to the utilisation of eight visits or more among women in SSA. CONCLUSION: This study shows the disparities in ANC coverage, contingent upon wealth index and educational attainment. Our study highlights the importance of adopting a holistic approach involving robust cooperation between healthcare and other social service sectors. It is crucial to prioritise the primary social factors contributing to disparities in the utilisation of ANC services, including women's education, parity, place of residence, and economic status. Policymakers and stakeholders must prioritise efforts to combat obstacles to healthcare access, including the provision of easily accessible, affordable, and culturally appropriate services.