title: The relationship between antenatal provider type and maternal care in rural Ghana: a cross-sectional study.
abstract: OBJECTIVE
  To investigate the influence of antenatal provider type on maternity care in rural Ghana.
  
  
  METHODS
  An analysis of maternal care by antenatal provider type using the 2008 Ghana Demographic and Health Survey. Study population included rural Ghanaian women aged 15-49 years with report of a live birth between 2003 and 2008. Bivariate chi-square analysis was performed to examine differences in maternal report of WHO Maternal Health Interventions. Multivariate linear and logistic regression were performed to assess differences in antenatal care (ANC) scales and maternal care packages.
  
  
  RESULTS
  Thousand and three hundred and sixty-seven rural women reported a live birth. Provider distribution was: doctor, 15.6%; midwife, 70%; community health officer (CHO), 9.1%; no provider, 5.3%. Women from lower socio-demographic categories were more likely to report midwife or CHO. Report of CHO vs. no provider was positively associated with maternal services (P < 0.01). Report of doctor or midwife vs. CHO was significantly associated with maternal services (P < 0.01).
  
  
  CONCLUSIONS
  There is a positive association between antenatal provider length of training and maternal specialization and report of maternal services. Community-based providers are associated with markedly increased report of maternal services compared with no provider. Structural factors appear to underlie some differences in service provision.
authors.affiliation: Division of Academic General Pediatrics, University of Minnesota, Minneapolis, MN, USA. Sarah_Atunah-Jay@brown.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Atunah-Jay
authors.forename: S
authors.initials: S
authors.lastname: Pettingell
authors.forename: S-A
authors.initials: SA
authors.lastname: Ohene
authors.forename: J
authors.initials: J
authors.lastname: Michael Oakes
authors.forename: I W
authors.initials: IW
authors.lastname: Borowsky
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006293:Health Promotion; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult