title: EXPLAINING THE GAP IN ANTENATAL CARE SERVICE UTILIZATION BETWEEN YOUNGER AND OLDER MOTHERS IN GHANA.
abstract: Over two-thirds of pregnant women (69%) have at least one antenatal care (ANC) coverage contact in sub-Saharan Africa. However, to achieve the full life-saving potential that ANC promises for women and babies, a nuanced understanding of age-specific gaps in utilization of ANC services is required. Using the 2008 Ghana Demographic and Health Survey of 1456 individuals, this study examined the disparities in the use of ANC services between younger and older mothers by applying four counterfactual decomposition techniques. The results show that cross-group differences in the explanatory variables largely account for the differentials in ANC service utilization between younger and older mothers. Birth order (parity) accounts for the largest share of the contribution to the overall explained gap in ANC utilization between the younger and older mothers, suggesting that ANC differentials between the two groups are probably due to biosocial factors. To a lesser extent, wealth status of the two groups also contributes to the overall explained gap in ANC service utilization. The policy implications of these findings are that in order to bridge the ANC service utilization gap between the two groups, policymakers must systematically address gaps in cross-group differences in the explanatory variables in order to increase the utilization of ANC to attain the minimum recommendation of four visits as per World Health Organization guidelines.
authors.affiliation: *Arthur Labatt Family School of Nursing,Health Sciences Addition,University of Western Ontario,London,ON,Canada.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Boamah
authors.affiliation: †Department of Sociology,University of Western Ontario,London,ON,Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Amoyaw
authors.affiliation: ‡Department of Geography,University of Western Ontario,London,ON,Canada.
authors.forename: Isaac
authors.initials: I
authors.lastname: Luginaah
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D005260:Female; D005544:Forecasting; D005869:Ghana; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality / Q000639:trends; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014600:Utilization Review; D055815:Young Adult