DETERMINANTS OF THE UTILISATION OFSKILLED DELIVERY SERVICES BY PREGNANT WOMEN IN THE CENTRAL REGION, GHANA

ABSTRACT

The purpose of this study was to investigate the determinants of utilisation of skilled  delivery  service  (SDS)  by  pregnant  women  at  health  facilities  in  the Central Region  of  Ghana.  A descriptive cross-sectional  design  was  used  to conduct the study. A multi-stage sampling technique was used to sample 1100 pregnant women. Questionnaire was used to collect the data after pretesting was done and the collected data were analysed using frequencies, percentages and binary logistic regression were used to analyse the data. SPSS version 21was used to analysed  the  data.  The  results  showed  that  majority  of  the  pregnant women had the intention to use SDS during labour. The factors that were found to determine the use of SDS were religion, person who takes decision  at  delivery place, number of antenatal care (ANC) visits for the index child, place of last delivery, having experienced miscarriage in life and level of satisfaction with last delivery services. Attitude of staff, privacy, demand for items from pregnant women, mothers who needed closer attention from relatives and road network were the factors that correlate with SDS use. To improve maternal mortality, it is imperative to address the determinants of SDS use.  It is recommended that future  studies  focus  more  on  investigating  why  the  Muslim  minority  in  the Central Region are unlikely to use SDS. The Ghana Health Service (GHS) and Ministry of Health (MOH) should put measures in place to prevent midwives from  illegally  extorting  items  from  pregnant  women.  Health  care  providers should adopt incessant health education and behaviour change communication strategies  to  increase  the  propensity  for  SDS  use.  Health  service  providers should ensure client and family-centered care to make the health facilities user friendly.