Ethnic disparities in utilisation of maternal health care services in Ghana: evidence from the 2007 Ghana Maternal Health Survey.
OBJECTIVE
Disparities in utilisation of maternal health care remain a challenge to attainment of the maternal health-related Millennium Development Goals. The objective of this descriptive study was to examine disparities in utilisation of maternal health care among ethnic groups in Ghana.


METHODS
Data from the 2007 Ghana Maternal Health Survey were analysed for disparities in antenatal care (ANC) visit, utilisation of tetanus toxoid immunisation and iron tablets/syrup intake during pregnancy, place of delivery, skilled birth attendance, caesarean section (CS) and post-natal care (PNC) among different ethnic groups.


RESULTS
Findings show that the proportion of women who received any form of skilled antenatal, delivery and PNC in the five years (2003-2007) preceding the survey was 96%, 55% and 55%, respectively. Despite the incremental progress Ghana made in improving access to skilled maternal health care services, large gradients of disparities exist. The ethnic difference in utilisation of institutional prenatal care was small; however, fewer births to women from majority ethnic groups such as the Akan (21%) took place at home compared with births to women from minority ethnic groups such as the Ewe (58.8%), Guan (42.7%), Grusi (53.4%), Mole-Dagbani (74.7%) and Gruma (58.8%). The rate of consultation of a skilled health care provider for delivery among the different ethnic groups also ranged from a low of 27% for births to Mole-Dagbani women to a high of 68.8% among births to Akan women.


CONCLUSIONS
Minority ethnic groups reported lower utilisation levels for most of the components of skilled maternity care in Ghana. However, ethnic disparities in utilisation of all the components of ANC in Ghana were less compared to delivery in health facilities, skilled attendance at birth, use of CS and PNC. Therefore, efforts to promote universal access to skilled maternity care not only should target those sub-populations with significantly low utilisation levels but also must focus on those components of maternal health care such as skilled attendance at delivery that demonstrate the greatest disparities. There is also the need to further explore who continues to remain excluded from receiving needed care, and how to encourage such women, especially minority women, to seek skilled care.
a Population, Health and Gender Research Group, Department of Geography & Rural Development, Faculty of Social Sciences , Kwame Nkrumah University of Science & Technology , Kumasi , Ghana.
John Kuumuori
JK
Ganle
D000293:Adolescent; D000328:Adult; D005006:Ethnicity; D005260:Female; D005869:Ghana; D006297:Health Services Accessibility; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs; D008427:Maternal Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D036301:Qualitative Research; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
Ghana; ethnic disparities; ethnic minorities; ethnicity; maternal health care; utilisation