Dotse-Gborgbortsi, Winfred, Worlanyo, Dwomoh, Duah, Alegana, Victor, Hill, A G, Tatem, Andrew and Wright, James (2020) The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana. BMJ Global Health, 4 (e002020), [e002020]. (doi:10.1136/bmjgh-2019-002020).
Abstract
Objectives: Skilled birth attendance is the single most important intervention to reduce maternal mortality. However, studies have not used routinely collected health service birth data at named health facilities to understand the influence of distance and quality of care on childbirth service utilisation. Thus, this paper aims to quantify the influence of distance and quality of healthcare on utilisation of birthing services using routine health data in Eastern Region, Ghana.
Methods: We used a spatial interaction model (a model that predicts movement from one place to another) drawing on routine birth data, emergency obstetric care surveys, gridded estimates of number of pregnancies and health facility location. We compared travel distances by sociodemographic characteristics and mapped movement patterns.
Results: A kilometre increase in distance significantly reduced the prevalence rate of the number of women giving birth in health facilities by 6.7%. Although quality care increased the number of women giving birth in health facilities, its association was insignificant. Women travelled further than expected to give birth at facilities, on average journeying 4.7 km beyond the nearest facility with a recorded birth. Women in rural areas travelled 4 km more than urban women to reach a hospital. We also observed that 56% of women bypassed the nearest hospital to their community.
Conclusion: This analysis provides substantial opportunities for health planners and managers to understand further patterns of skilled birth service utilisation, and demonstrates the value of routine health data. Also, it provides evidence based information for improving maternal health service provision by targeting specific communities and health facilities.
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- Faculties (pre 2018 reorg) > Faculty of Engineering and the Environment (pre 2018 reorg) > Southampton Marine & Maritime Institute (pre 2018 reorg)
- Current Faculties > Faculty of Environmental and Life Sciences > School of Geography and Environmental Sciences
School of Geography and Environmental Sciences - Current Faculties > Faculty of Environmental and Life Sciences > School of Geography and Environmental Sciences > Population, Health and Wellbeing (PHeW)
School of Geography and Environmental Sciences > Population, Health and Wellbeing (PHeW) - Current Faculties > Faculty of Social Sciences > School of Economic Social and Political Science > Social Statistics and Demography
School of Economic Social and Political Science > Social Statistics and Demography - Current Faculties > Faculty of Environmental and Life Sciences > School of Geography and Environmental Sciences > Population, Health and Wellbeing (PHeW) > WorldPop
School of Geography and Environmental Sciences > Population, Health and Wellbeing (PHeW) > WorldPop
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