Introduction: Utilisation of skilled birth attendants in health facilities is crucial for improving maternal and child health. In low-income countries, a significant proportion of women give birth in non-health facilities compared to high-income countries. Studies in Ghana have revealed that approximately a quarter of women deliver at home. Data available in the district health information management system revealed that Asutifi North District recorded 38.5%, 41.5%, and 39.7% for skilled delivery in 2020, 2021 and 2022, respectively, which are below the national target of 65%. Various factors, including proximity to healthcare facilities, transportation costs, availability of transportation to healthcare facilities, educational attainment, previous childbirth experiences in healthcare settings, antenatal care attendance, and individual preferences, influence home delivery. The Asutifi North District faces challenges in meeting the national target for skilled deliveries, which may be attributable to these perceived determinants. To guide focused health interventions to address the problem of home delivery, we estimated its prevalence and associated factors among women attending Child Welfare Clinics (CWC) in the Asutifi North District, Ghana. Methods: We conducted a cross-sectional study among 406 mothers attending CWC in the Asutifi North District. A multistage sampling method was used to select respondents for this study. Initially, the district was stratified into sub-districts, and mothers were randomly selected from the Child Welfare Clinic (CWC) registers and followed up to respond to a semi-structured questionnaire to assess factors associated with home delivery. Home delivery was the outcome variable and exposure variables were sociodemographic characteristics, obstetric characteristics and health facility-related factors. We performed a chi-square test and logistic regression to assess the factors associated with home delivery. Results: A home delivery prevalence of 21.4% was estimated in Asutifi North District. Home delivery had a positive association with marital status (AOR = 2.27, 95% CI= 0.96- 5.36, p= 0.061) and a partner with basic school education level (AOR=5.44; 95% CI= 1.19- 24.97, p= 0.029). Home delivery also showed a relationship with travel time to health facilities (AOR= 9.10; 95% CI= 3.69- 22.44, p= <0.001), and never attending ANC (AOR= 3.91; 95% CI= 1.19- 12.89, p= 0.025). Conclusion: Our study revealed that approximately a quarter of mothers delivered at home. Shorter travel time to a health facility, partner’s low educational status, ANC non-attendance have significant relationships with home delivery. The Ghana Health Service should collaborate with the district assemblies and health development partners to build health facilities close to the community members, empower communities through educational opportunities, intensify home visits to encourage ANC attendance, and increase effective counselling in maternal health services.
Abanga et al. (Mon,) studied this question.
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