MCH Student:

Sarah Atunah-Jay

Date of Defense:

September 16, 2013

Abstract:

Objectives: To assess the association between maternal care and healthcare provider type  in Ghana, so as to better inform prioritization of health worker capacity building efforts.

Methods: An analysis of maternal care by antenatal provider type  using the cross- sectional 2008 Ghana Demographic and Health Survey. Study population included rural  Ghanaian women age 15-49 years with report of  a live birth in the five years preceding  the survey. Bivariate chi-square analysis  was performed to examine differences by  antenatal provider type in maternal report of WHO-recommended Maternal Health  Interventions. Multivariate linear and logistic regressions were performed to assess the  effect of provider type on antenatal care  (ANC) scales and maternal care packages.

Results: 1,367 rural women reported a live birth in the five years preceding the survey.  Provider distribution included:  doctor, 15.6%; midwife, 70%;  community health officer  (CHO), 9.1%; and no provider, 5.3%.  Women  who reported receiving care from a doctor  were from the highest sociodemographic profiles. Report of ANC from a CHO, as  compared to reporting no provide r, was significantly associated with report of maternal  services. Report ANC from a doctor or midwife, as compared to a CHO, was  significantly associated with report of maternal services.

Conclusion: There are differences in maternal car e between skilled provider categories.   The largest gap in report of  care lies between skilled providers and no providers. Health  system strengthening efforts require increased  information on health workforce activities  to best inform training priorities and resource allocation.