Utilization of health facility delivery services in the Jomoro District of the Western Region of Ghana

Background: In the year 2000, member states of the United Nations pledged to work towards a three-quarters reduction in the 1990 maternal mortality ratio by 2015 in line with Millenium. Development Goal 5, but this could not be achieved. This pledge became imperative given the high maternal mortality being recorded, especially among developing countries. The high maternal deaths in developing countries have been attributed partly to the lack of access to skilled birth attendants during delivery. Objective: This study aimed to investigate factors that influence the utilization of health facility delivery services among pregnant women in the Jomoro District of the Western Region of Ghana. Methods: The study used data from a cross-sectional survey among women aged 18 - 49 yr. living in the Jomoro District of Ghana and had given birth between 2012 and 2016 (n = 374). The study participants were randomly selected from women who attended child welfare clinics on clinic days with their babies in eighteen communities. The study used a structured questionnaire to solicit for information about the women’s demographic and socio-economic characteristics, community characteristics and health systems factors likely to influence their decision to seek skilled delivery care as well as their experiences relating to their last delivery. Bivariate analyses were performed between the primary dependent variable and background characteristics of the respondents. Factors influencing the choice of place of delivery were estimated by multiple logistic regression analysis. Data analysis was performed using STATA Statistical Software, Release 14. Results: About 61.0% (n= 228/374) of the women had their last delivery at a health facility while the remaining 38.8% (n= 145/374) delivered at home without skilled assistance. In multivariate analysis, women aged 25 – 29 yr. were less likely to have a skilled delivery (aOR, 0.40; 95% CI: 0.17 - 0.93). Also, professional women had 4.77 odds of having skilled delivery (aOR, 4.77; 95% CI: 1.53 - 14.93). Distance to the nearest health facility also had a statistically significant association with skilled delivery. Women living at 10 – 19 km to a health facility were less likely to have a skilled delivery (aOR, 0.56; 95% CI: 0.32 - 0.97). In addition, the presence of a midwife at a health facility increased the odds of skilled delivery among women (aOR, 4.59; 95% CI: 2.47 - 8.55). Conclusion: Interventions aimed at increasing the uptake of delivery care services to achieve the SDG’s target on maternal mortality must consider improving the socio-economic wellbeing of women in addition to removing the physical and health system barriers impeding access and utilisation of delivery care services.