ABSTRACTNo. 1Course

MPHNameJohn HammondThesis

A cross-sectional study to evaluate access to antenatal care

Title

services in Twifo Hemang Lower Denkyira district, Ghana

Background: Antenatal care (ANC) is an essential component of reproductive,maternal, newborn, and child health continuum of care. It is positively correlatedwith high supervised delivery and the reduction of maternal death. However, inlower economic countries, limited access to skilled care during pregnancy increases
the risk of maternal death for vulnerable groups. Socio-cultural, economic,demographic, and geographical factors have been linked to timely and continuous
ANC. In Ghana, few studies have explored how ANC is influenced by theCommunity-based Health Planning and Services (CHPS) policy, and in theCentral Region, evidence is non-existent. Hence, it is imperative to highlight
factors that influence access to ANC services in a rural setting.
Objective: The main objective is to determine factors that influence access to ANC

services provided through the CHPS policy for women in the Twifo Hemang Lower
Denkyira District, Ghana. Specific objectives are to examine the influence of sociodemographic and socio-economic factors on access to timely ANC services,
ascertain the level of knowledge and awareness of ANC, and determine the extent
to which distance and location of CHPS compound affect access to ANC.
Methods: A cross-sectional study examined 310 postpartum women aged 15-49

years with children 12 months or younger selected from households, using astructured questionnaire. Bivariate and multivariate logistic regression analysis
was conducted using STATA 17 to identify factors associated with at least one
ANC attendance and time of ANC initiation, and results were reported asunadjusted and adjusted odds ratios.
＊ The abstract, containing background, objectives, methods, results and conclusion should not exceed 300-500words andprinted double sided on A4 paper)

No. 2Course

MPH

Name

John Hammond

Results: It revealed that skilled ANC attendance (93.9%) and early ANC initiation(69.1%) were high. In the multivariate logistic regression, home delivery (AdjustedOdds Ratio [AOR]=0.013; 95% Confidence Interval [95%CI]:0.001-0.178) andunmarried women (AOR=0.126, 95% CI 0.013-1.250) had reduced odds ofattending at least one ANC during pregnancy. Pregnant women who made lessthan four ANC visits (AOR=6.101; 95% CI:1.961-18.988), those who received homevisits (AOR=1.817; 95% CI:1.015-3.252), and those with larger family sizes(AOR=4.499; 95% CI:1.085-18.663) had higher odds of initiating first ANC visit
late. Respondents’ average monthly income (AOR=0.161; 95% CI:0.030-0.877) was
positively associated with initiating ANC early. Knowledge about ANC andpregnancy (96.5%) and CHPS compounds as a source of ANC service (71.8%) werehigh, however, they were not statistically associated with ANC attendance andtime of ANC initiation at the multivariate level.
Conclusion: Making at least one skilled ANC attendance and early ANC initiation

was high among the respondents. Being unmarried and delivering at homeassociated negatively with attending at least one ANC. Having larger family size,
making less than four ANC visits, and receiving home visit from health staff posed
as barriers for women to initiate ANC early. Additionally, average monthly income
had a positive association with early ANC initiation. However, receiving ANC
services from CHPS compound and having good knowledge about ANC andpregnancy, were not statistically associated with either ANC attendance or timeof ANC initiation. The complexities in these factors requires multi-sectoral
approach to strengthen community-based services to give these women a chance
to survive. (496)＊ The abstract, containing background, objectives, methods, results and conclusion should not exceed 300-500words andprinted double sided on A4 paper)