Socio-demographic determinants of skilled birth attendant at delivery in rural southern Ghana.

BACKGROUND: Maternal mortality is the subject of the United Nations' fifth Millennium Development Goal, which is to reduce the maternal mortality ratio by three quarters from 1990 to 2015. The giant strides made by western countries in dropping of their maternal mortality ratio were due to the recognition given to skilled attendants at delivery. In Ghana, nine in ten mothers receive antenatal care from a health professional whereas only 59 and 68% of deliveries are assisted by skilled personnel in 2008 and 2010 respectively. This study therefore examines the determinants of skilled birth attendant at delivery in rural southern Ghana. METHODS: This study comprises of 1874 women of reproductive age who had given birth 2 years prior to the study whose information were extracted from the Dodowa Health and Demographic Surveillance System. The univariable and multivariable associations between exposure variables (risk factors) and skilled birth attendant at delivery were explored using logistic regression. RESULTS: Out of a total of 1874 study participants, 98.29% of them receive antenatal care services during pregnancy and only 68.89% were assisted by skilled person at their last delivery prior to the survey. The result shows a remarkable influence of maternal age, level of education, parity, socioeconomic status and antenatal care attendance on skilled attendants at delivery. CONCLUSION: Although 69% of women in the study had skilled birth attendants at delivery, women from poorest households, higher parity, uneducated, and not attending antenatal care and younger women were more likely to deliver without a skilled birth attendants at delivery. Future intervention in the study area to bridge the gap between the poor and least poor women, improve maternal health and promote the use of skilled birth at delivery is recommended.

Socioeconomic and demographic determinants of birth weight in southern rural Ghana: evidence from Dodowa Health and Demographic Surveillance System.

BACKGROUND: Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. It also results in substantial costs to the health sector and imposes a significant burden on the society as a whole. This study seeks to investigate the determinants of low birth weight and the incidence of LBW in southern rural Ghana. METHODS: Pregnancy, birth, demographic and socioeconomic information of 6777 mothers who gave birth in 2011, 2012, and 2013 and information on their babies were extracted from a database. The database of Dodowa Health and Demographic Surveillance System is a longitudinal follow-up of over 24,000 households. The incidence of LBW was calculated and the univariable and multivariable associations between exposure variables and outcome were explored using logistic regression. STATA 11 was used for the analyses. RESULT: The results revealed that 40.21 % of the infants were not weighed at birth and the incidence of LBW for 2011 to 2013 was 8.72, 7.04 and 7.52 % respectively. Women aged 20-24, 25-29, 30-34 years were more than twice more likely to have babies weighing ≥2.5 kg compared to those <20 years (OR:2.32, 95 % CI:1.65-3.26, OR:2.73, 95 % CI:1.96-3.79, OR:2.87, 95 % CI:2.06-4.01) and mothers who were >34 years were more than three times more likely to have babies weighed ≥2.5 kg (OR: 3.59, 95 % CI:2.56-5.04). Mothers who were civil servants were 77 % more likely to have babies weighed ≥2.5 kg (OR: 1.77, 95 % CI: 1.99-2.87) compared to those who were unemployed. After adjusting for other explanation variables, mothers from poorer households were 30 % more likely to have babies who weighed ≥2.5 kg (OR: 1.30, 95 % CI: 1.01-1.66) compared to those from the poorest households. Women with parity2 and parity > 3 were 30 % and 81 % more likely to have babies weighing ≥2.5 kg (OR: 1.30, 95 % CI: 1.03-1.63, OR: 1.81, 95 % CI: 1.38-2.35) compared to those with parity1. Male infants were 52 % more likely to weigh ≥2.5 kg at birth (OR: 1.52, 95 % CI: 1.32-1.76) compared to females. CONCLUSION: Our study revealed that having infant birth weight ≥ 2.5 kg is highly associated with socioeconomic status of women household, the gender of an infant, parity, occupation and maternal age.