title: Quality of antenatal care services in the Birim North District of Ghana: contribution of the community-based health planning and services program.
abstract: To compare the quality of antenatal care (ANC) between Community-based Health Planning and Services (CHPS) and non-CHPS areas in the Birim North District of Ghana. A cross-sectional study was conducted in May, 2010. We collected data from 600 women (300 from CHPS areas and 300 from non-CHPS areas) recruited from six CHPS and six non-CHPS areas, using a structured questionnaire. Participants were aged 15-49 years, had at least one child within 18 months old, and resided in the district for at least 2 years before data collection. Outcomes included: (1) index of ANC utilization (dichotomized as full and partial), (2) receipt of anti-malarial drugs, (3) testing for HIV infection, and (4) index of knowledge about pregnancy danger signs (expressed in tertiles). Descriptive statistics and multivariate logistic regression methods were employed in the analysis. Multivariate analysis revealed that participants in the CHPS areas were 2.7 times (95% CI: 1.66-4.35) more likely to have full utilization score, 4.5 times (95% CI: 2.37-8.51) more likely to receive HIV testing, and 3.7 times (95% CI: 1.72-7.94) more likely to receive anti-malarial prophylaxis during the ANC period. However, scoring high on the index of knowledge was not significantly associated with the CHPS exposure (OR: 1.2; 95% CI: 0.69-2.00). The CHPS intervention might be useful to improve the quality of ANC. Therefore, increasing the CHPS intervention coverage in non-CHPS areas might serve as a basis for improving the quality of ANC in the Birim North and other rural districts of Ghana.
authors.affiliation: Department of Community and Global Health, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-0033, Japan.
authors.forename: Sharon
authors.initials: S
authors.lastname: Naariyong
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Poudel
authors.forename: Mosuir
authors.initials: M
authors.lastname: Rahman
authors.forename: Junko
authors.initials: J
authors.lastname: Yasuoka
authors.forename: Keiko
authors.initials: K
authors.lastname: Otsuka
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage; D018672:Community Health Planning / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008288:Malaria / Q000517:prevention & control; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000517:prevention & control; D011295:Prenatal Care / Q000592:standards* / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000962:Antimalarials