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Public health
Research
Inequality trends in maternal health services for young Ghanaian women with childbirth history between 2003 and 2014
  1. Benedict Oppong Asamoah,
  2. Anette Agardh
  1. Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmo, Sweden
  1. Correspondence to Dr Benedict Oppong Asamoah; benedict_oppong.asamoah{at}med.lu.se

Abstract

Objective To achieve universal coverage of reproductive healthcare and drastic reduction in maternal mortality, adequate attention and resources should be given to young women. This study therefore aimed to examine the inequality trends in the use of antenatal care (ANC) services and skilled birth attendance (SBA) within a subgroup of Ghanaian women aged 15–24 years between 2003 and 2014.

Design This is a cross-sectional study that used data from the Ghana Demographic and Health Surveys (DHS) 2003, 2008 and 2014. We applied regression-based total attributable fraction (TAF) as an index for measuring multiple dimensions of inequality in the use of ANC and SBA.

Setting Ghana.

Participants Young women aged 15–24 years with at least one previous birth experience in the past 5 years prior to the surveys.

Main outcome measures ANC visits and skilled attendance at birth.

Results Urbanicity-related, education-related and wealth-related inequality in non-use of SBA declined between 2003 and 2008, but increased between 2008 and 2014. A consistent decline was observed in urbanicity-related inequality in non-use of four or more ANC visits from 2003 through 2008 to 2014. A similar reduction was observed for education-related inequality in relation to the same outcome. In contrast, wealth-related inequality in ANC usage increased over time.

Conclusions The rise in urbanicity-related, education-related and wealth-related inequality in the usage of SBA between 2008 and 2014 threatens the sustainability of the general progress made in the usage of maternal health services in Ghana within the same period.

  • Ghana
  • Youth
  • sexual and reproductive health
  • skilled birth attendance
  • antenatal care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-011663

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    Footnotes

    • Contributors BOA participated in the conception and design of the study, data analysis, interpretation of the results, drafting and review of the manuscript. AA participated in the conception of the study, interpretation of the results and critical review of the manuscript.

    • Competing interests None declared.

    • Ethics approval Ghana Health Service Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data sets used for this study are available on request from the DHS Program (at http://dhsprogram.com/data/available-datasets.cfm).