title: Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.
abstract: Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014.
  
  
  
  The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services.
  
  
  
  The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses.
  
  
  
  To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour change communication campaigns.
authors.affiliation: Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. nadicx@gmail.com.
authors.forename: Kwamena Sekyi
authors.initials: KS
authors.lastname: Dickson
authors.affiliation: Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Eugene Kofuor Maafo
authors.initials: EK
authors.lastname: Darteh
authors.affiliation: Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Akwasi
authors.initials: A
authors.lastname: Kumi-Kyereme
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005260:Female; D005869:Ghana / Q000453:epidemiology; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000458:organization & administration / Q000592:standards; D008428:Maternal Mortality / Q000639:trends; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration / Q000592:standards; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: Antenatal care services; Ghana; Providers; Utilisation; Women