Factors Influencing Utilization of Skilled Delivery Services in Jomoro District in The Western Region of Ghana

ABSTRACT

Background: A delivery is measured skilled when it is done by a certified professional such as a midwife, doctor or a nurse, who can manage normal pregnancies, childbirth and immediate postnatal period, and to identify, manage and if indicated, or refer women and newborns with complications. Women in Sub-Saharan Africa lack skilled health care during gestation and delivery, with the majority delivering at home by traditional birth attendants (TBA). Several factors prevent women in SSA from finding quality health care services from the formal sector due to deprived access to health facilities and poor roads, transportation lack, poverty, cultural practices, poor knowledge, and poor quality health services. This is similar to the situation in the Jomoro district. The aim of the study was to identify the factors that influence skilled delivery services in Jomoro district. Methods: A cross sectional study was carried out on the factors influencing utilization of skilled delivery services among women between 18-49 years. Simple random sampling method was used to select eighteen Child Welfare Clinics, three in each sub-district in the district. Purposive sampling method was used to select mothers who have children less five years. Structured questionnaires were used for data collection. The data were analyzed using STATA Version14. Univariate analysis was conducted and the results were presented in frequencies, percentages, tables and figures. Association between x skilled delivery and related factors were determined at 95% confidence interval and level of significance of P=0.05 and the results are presented in tables. Results: Most (about 43%) of the respondents for the study fell within the 25-34 years age group. Christians formed (79.95%) among all respondents. Although, it may seem majority of respondents (58.56%) who had skilled delivery were Primary/Junior High graduates, respondents with tertiary education 15(4.0%) out of which 13 out of every 15 females with tertiary education, (86.7%) were delivered by a skilled personnel. The overall skilled delivery usage among respondents was 61.6% and 38.4% used the unskilled services of traditional birth attendants (TBA) and close relatives. Others also did self-delivery. This study did not find any cultural or religious beliefs that hinder utilization of skilled delivery services in the Jomoro. Most participants were pleased with the attitude of staff describing them as having very good attitude (54.8%). On the other hand some said staff attitude was poor, describing them as insulting and unfriendly. Poor attitude seems to deter mothers from using skilled attendant services. Most participants said staffs attitude has encouraged them to use skilled delivery services. Others include shouting at pregnant women, extortion of money and items such as soap Dettol and detergents for delivering skilled services. On cost of service delivery across the Jomoro district, about (33.4%) of respondents had free maternal health care for skilled delivery services. The majority (about 66.6%) paid for services ranging between (Ȼ20.00 to Ȼ440.00).