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On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis

On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis
On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis
Spatial inequalities related to the choice of delivery care have not been studied systematically in Sub-Saharan Africa where maternal and perinatal health outcomes continue to worsen despite a range of safe motherhood interventions. Using retrospective data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the extent of changes in spatial inequalities associated with type of delivery care in Ghana with a focus on rural–urban differentials within and across the three ecological zones (Savannah, Forest and Coastal). More than one-half of births in Ghana continue to occur outside health institutions without any skilled obstetric care. While this is already known, we present evidence from multilevel analyses that there exist considerable and growing inequalities, with regard to birth settings between communities, within rural and urban areas and across the ecological zones. The results show evidence of poor and disproportionate use of institutional care at birth; the inequalities remained high and unchanged in both urban and rural communities within the Savannah zone and widening in urban communities of the Forest and Coastal zones. The key policy challenges in Ghana, therefore, include both increasing the uptake of institutional delivery care and ensuring equity in access to both public and private health institutions
institutional births, home births, demographic health surveys, Ghana, multilevel modelling
0094-5145
64-72
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5
Padmadas, S.S.
64b6ab89-152b-48a3-838b-e9167964b508
Brown, J.J.
13ba046e-a946-4a7f-8e95-36283361448e
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5
Padmadas, S.S.
64b6ab89-152b-48a3-838b-e9167964b508
Brown, J.J.
13ba046e-a946-4a7f-8e95-36283361448e

Amoako Johnson, F., Padmadas, S.S. and Brown, J.J. (2009) On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis. Journal of Community Health, 34 (1), 64-72. (doi:10.1007/s10900-008-9120-x).

Record type: Article

Abstract

Spatial inequalities related to the choice of delivery care have not been studied systematically in Sub-Saharan Africa where maternal and perinatal health outcomes continue to worsen despite a range of safe motherhood interventions. Using retrospective data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the extent of changes in spatial inequalities associated with type of delivery care in Ghana with a focus on rural–urban differentials within and across the three ecological zones (Savannah, Forest and Coastal). More than one-half of births in Ghana continue to occur outside health institutions without any skilled obstetric care. While this is already known, we present evidence from multilevel analyses that there exist considerable and growing inequalities, with regard to birth settings between communities, within rural and urban areas and across the ecological zones. The results show evidence of poor and disproportionate use of institutional care at birth; the inequalities remained high and unchanged in both urban and rural communities within the Savannah zone and widening in urban communities of the Forest and Coastal zones. The key policy challenges in Ghana, therefore, include both increasing the uptake of institutional delivery care and ensuring equity in access to both public and private health institutions

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More information

Published date: February 2009
Keywords: institutional births, home births, demographic health surveys, Ghana, multilevel modelling
Organisations: Social Statistics

Identifiers

Local EPrints ID: 51995
URI: http://eprints.soton.ac.uk/id/eprint/51995
ISSN: 0094-5145
PURE UUID: f6c47187-dc41-4cec-8351-855e31078743
ORCID for S.S. Padmadas: ORCID iD orcid.org/0000-0002-6538-9374

Catalogue record

Date deposited: 13 Jun 2008
Last modified: 16 Mar 2024 03:33

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Contributors

Author: F. Amoako Johnson
Author: S.S. Padmadas ORCID iD
Author: J.J. Brown

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