Skip to main content

Advertisement

SpringerLink
Log in

Type of Health Facility and Utilization of Antenatal Care Services Among Ghanaian Women

  • Published:
Population Research and Policy Review Aims and scope Submit manuscript

Abstract

This study examined if differences exist in the number and timing of antenatal care (ANC) visits for users of public and private health care facilities in Ghana. Also, the study explored if such variations could be attributed to health-provider factors or the selective socioeconomic characteristics of the users. Data were drawn from the recently collected Ghana Demographic and Health Survey and from a representative sample of t 2135 women who attended antenatal care in a health facility 6 months preceding the survey. Random-effects Poisson and logit models were employed for analysis. Results showed statistically significant differences between users of private and public health facilities for number of ANC visits, but not for the timing of such visits. Although some health-provider factors were significantly associated with ANC visits, these factors did not explain why users of private health facilities had significantly higher number of ANC visits than users of public health facilities. Differences in ANC visits for both private and public health facilities were rather explained by the selective socioeconomic characteristics of the users, especially as wealthy and educated women patronized private health care than poorer and uneducated women. The study concludes that Ghanaian women attending private health facilities may not have improved access to antenatal care compared to those attending public health facilities, and adds to the emerging body of literature that questions private health care in sub-Saharan Africa as more effective than public health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adesanya, T., Gholahan, O., Ghannam, O., Miraldo, M., Patel, B., Verma, R., et al. (2012). Exploring the responsiveness of public and private hospitals in Lagos. Journal of Public Health Research, 1, e2.

    Article  Google Scholar 

  • Afulani, P. A. (2015). Rural/urban and socioeconomic differentials in quality of antenatal care in Ghana. PLoS One, 10(2), e0117996. doi:10.1371/journal.pone.0117996.

    Article  Google Scholar 

  • Agha, S., & Keating, J. (2009). Determinants of the choice of a private health facility for family planning services among the poor: Evidence from three countries private sector partnerships-One project. Bethesda, MD: Abt Associates Inc.

    Google Scholar 

  • Aikins, I., & Ahmed, M. (2014). Assessing the role of quality service delivery in client choice for healthcare: A case of Bechem Government Hospital and Green Hill Hospital. European Journal of Logistics and Supply Chain Management, 2(3), 1–23.

    Google Scholar 

  • Asamoah, B. O., Agardh, A., Pettersson, A. O., & Ostergren, P. (2014). Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988-2008. BMC Pregnancy and Childbirth, 14, 295.

    Article  Google Scholar 

  • Baffuor-Awuah, A., Mwini-Nyaledzigbor, P. P., & Richter, S. (2015). Enhancing focused antenatal care in Ghana: an exploration into perceptions of practicing midwives. International Journal of Africa Nursing Sciences, 2, 59–64.

    Article  Google Scholar 

  • Banchani, E., & Tenkorang, E. Y. (2014). Occupational types and antenatal care attendance among women in Ghana. Health Care for Women International, 35(7–9), 1040–1064.

    Article  Google Scholar 

  • Basu, S., Andrews, J., Kishore, S., Panjabi, R., & Stuckler, D. (2012). Comparative performance of private and public healthcare systems in low- and middle-income countries: A systematic review. PLoS Medicine, 9(6), 1–14.

    Article  Google Scholar 

  • Chaitkin, M., Schnure, M., Dickerson, D., & Alkenbrack, S. (2015). How Ghana can save lives and money: The benefits of financing family planning through national health insurance. Washington, DC: Futures Group, Health Policy Project.

    Google Scholar 

  • Chama-Chiliba, C. M., & Koch, S. F. (2013). Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis. Health Policy & Planning, 30(1), 78–87.

    Article  Google Scholar 

  • Dean, C., & Lawless, J. F. (1989). Tests for detecting over-dispersion in Poisson regression models. Journal of American Statistical Association, 84, 467–472.

    Article  Google Scholar 

  • Dixon, J., Tenkorang, E. Y., Luginaah, I. N., Kuuire, V. Z., & Boateng, G. O. (2014). National health insurance scheme and antenatal care in Ghana: Is there a relationship? Tropical Medicine & International Health, 19(1), 98–106.

    Article  Google Scholar 

  • Gaddah, M. & Munro, A. (2011). The progressivity of health care services in Ghana. GRIPS Discussion Paper 11–14. GRIPS Policy Research Center, Tokyo.

  • Ganle, J. K. (2015). Ethnic disparities in utilization of maternal health care services in Ghana: evidence from the 2007 Ghana Maternal Health Survey. Ethnicity & Health, 21(1), 85–101.

    Article  Google Scholar 

  • Ghana Development Planning Commission. (2015). Ghana Millennium Development Goals: 2015 Report. http://www.gh.undp.org/content/dam/ghana/docs/Doc/Inclgro/UNDP_GH_2015%20Ghana%20MDGs%20Report.pdf.

  • Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF International. (2015). Ghana Demographic and Health Survey 2014. Rockville, MD: GSS, GHS, and ICF International.

    Google Scholar 

  • Guo, G., & Zhao, H. (2000). Multilevel modeling for binary data. Annual Review of Sociology, 26, 441–462.

    Article  Google Scholar 

  • Harris, B., Goudge, J., Ataguba, J. E., McIntyre, D., Nxumalo, N., Jikwana, S., & Chersich, M. (2011). Inequities in access to health care in South Africa. Journal of Public Health Policy, 32, s102–s123.

  • Hera-Health Partners Ghana. (2013). Evaluation of the free maternal health care initiative in Ghana. Volume I (Main Report). http://www.unicef.org/evaldatabase/files/Ghana_130517_Final_Report.pdf

  • Hsu, J. (2010). The relative efficiency of public and private service delivery. World Health Report: Background Paper, 39. Geneva: WHO.

    Google Scholar 

  • Hutchinson, P. L., & Agha, S. (2011). Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana. BMC Health Services Research, 11, 203.

  • Jallow, I. K., Chou, Y., Liu, T., & Huang, N. (2012). Women’s perceptions of antenatal care services in public and private clinics in the Gambia. International Journal for Quality in Health Care, 24(6), 595–600.

    Article  Google Scholar 

  • Lawless, J. F. (1987). Negative binomial and mixed Poisson regression. The Canadian Journal of Statistics, 15, 209–225.

    Article  Google Scholar 

  • Lewis, M. (2006). Government and corruption in public health systems. Working paper no. 78. Washington, DC: Center for Global Development.

    Google Scholar 

  • Lincetto, O., Mothebesoane-Anoh, S., Gomez, P., & Munjanja, S. P. (2006). Antenatal care. In L. Joy & K. Kate (Eds.), Opportunities for Africa’s newborns: Practical data, policy and programmatic support for newborn care in Africa. Cape Town: PMNCH.

    Google Scholar 

  • Markinen, M., Sealy S., Bitran, R.A., Adjei, S. & Munoz, R. (2011). Private health sector assessment in Ghana. World Bank Working Paper Series No. 210.

  • Montagu, D. D., Anglemyer, A., Tiwari, M., Drasser, K., Rutherford, G. W., Horvath, T., et al. (2011). Private versus public strategies for health service provision for improving health outcomes in resource-limited settings. San Francisco, CA: Global Health Sciences, University of California, San Francisco. ISBN 978-1-907345-18-0.

    Google Scholar 

  • Mullahy, J. (1986). Specification and testing of some modified count data models. Journal of Econometrics, 33, 341–365.

    Article  Google Scholar 

  • Nketiah-Amponsah, E., & Hiemenz, U. (2009). Determinants of consumer satisfaction of health care in Ghana: Does choice of health care provider matter? Global Journal of Health Science, 1(2), 50–61.

    Article  Google Scholar 

  • Obuobi, A. A., Pappoe, M., Ofosu-Amaah, S. & Boni, D. Y. (1999). Private health care provision in Greater Accra Region of Ghana. Small Applied Research Paper 8. Partnership for Health Research, Harvard School of Public Health.

  • Olusanya, B. O., Roberts, A. A., Olufunlayo, T. F., & Inem, V. A. (2010). Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study. Health Policy, 96, 210–216.

    Article  Google Scholar 

  • Opoku, E. A. (2009). Utilization of Maternal Care services in Ghana by Region after the Implementation of the Free Maternal Care Policy, Fort Worth, TX: University of North Texas Health Science Center. Retrieved from http://digitalcommons.hsc.unt.edu/theses/78.

  • Ozawa, S., & Walker, D. G. (2011). Comparison of trust in public vs private health care providers in rural Cambodia. Health Policy and Planning, 26, 120–129.

    Article  Google Scholar 

  • Pebley, A. R., Goldman, N., & Rodriguez, G. (1996). Prenatal and delivery care childhood immunization in Guatemala: do family and community matter? Demography, 33, 231–247.

    Article  Google Scholar 

  • Pell, C., Menaca, A., Were, F., Afrah, N. A., Chatio, S., Manda-Taylor, L., et al. (2013). Factors Affecting Antenatal Care Attendance: Results from Qualitative Studies in Ghana, Kenya and Malawi. PLoS One, 8(1), e53747. doi:10.1371/journal.pone.0053747.

    Article  Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods. Newbury Park, CA: Sage Publications.

    Google Scholar 

  • Regidor, E., Martinez, D., Calle, M. E., Astasio, P., Ortega, P., & Dominguez, V. (2008). Socioeconomic patterns in the use of public and private health services and equity in health care. BMC Health Services Research, 8, 183. doi:10.1186/1472-6963-8-183.

    Article  Google Scholar 

  • Salisu, A., & Prinz, V. (2009). Health Care in Ghana. Report for the Austrian Centre for Country of Origin & Asylum Research and Documentation. https://www.ecoi.net/file_upload/90_1236873017_accord-healthcare-in-ghana-20090312.pdf.

  • Tuan, T., Dung, V., Nue, I., & Dibley, M. J. (2005). Comparative quality of private and public health services in rural Vietnam. Health Policy & Planning, 20(5), 319–327.

    Article  Google Scholar 

  • Turkson, P. K. (2009). Perceived quality of healthcare delivery in a rural district of Ghana. Ghana Medical Journal, 43(2), 65–70.

    Google Scholar 

  • United Nations. (2011). MDG Acceleration framework: operational note. Retrieved from http://www.undp.org/content/dam/undp/library/Poverty%20Reduction/MDG%20Strategies/MAF%20Operational%20Note.pdf.

  • Victoria, C. G., Matijasevich, A., Silveira, M. F., Santos, I. S., Barros, A. J. D., & Barros, F. C. (2009). Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil. Health Policy & Planning, 25, 253–261.

    Article  Google Scholar 

  • Waiswa, P., Akuze, J., Peterson, S., Kerber, K., Tetui, M., Forsberg, B. C., et al. (2015). Differences in essential newborn care at birth between private and public health facilities in eastern Uganda. Global Health Action, 8, 24251. doi:10.3402/gha.v8.24251.

    Google Scholar 

  • Wilunda, C., Quaglio, G., Putoto, G., Takahashi, R., Calia, F., Abebe, D., et al. (2015). Determinants of utilization of antenatal care and skilled birth attendant at delivery in South West Shoa Zone, Ethiopia: a cross sectional study. Reproductive Health, 12, 74. doi:10.1186/s12978-015-0067-y.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sociology, Memorial University of Newfoundland, St. John’s, NL, A1C 5A8, Canada

    Eric Y. Tenkorang

Authors
  1. Eric Y. Tenkorang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric Y. Tenkorang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tenkorang, E.Y. Type of Health Facility and Utilization of Antenatal Care Services Among Ghanaian Women. Popul Res Policy Rev 35, 631–650 (2016). https://doi.org/10.1007/s11113-016-9406-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11113-016-9406-0

Keywords

Search

Navigation