The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Sydney, Australia.
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
PLoS One. 2021 Jan 4;16(1):e0244811. doi: 10.1371/journal.pone.0244811. eCollection 2021.
In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana.
Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses.
We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17-0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06-3.86], women who professed other religions [AOR = 3.45; CI = 1.53-7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64-31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17-0.53], compared to those with no formal education.
The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so.
在加纳,与农村地区相比,城市地区的妇女选择在家分娩的比例相对较低。然而,在城市地区选择在家分娩的少数妇女仍面临着巨大的感染和死亡风险,这与农村地区的妇女一样。本研究调查了加纳城市地区选择在家分娩的妇女的相关因素。
本研究的数据来自 2014 年加纳人口与健康调查。我们使用了在调查前 5 年生育且居住在城市地区的 1441 名妇女的数据。我们使用 Stata 版本 14.2 进行了描述性和多变量逻辑回归分析。
我们发现,加纳城市地区有 7.9%的妇女选择在家分娩。研究表明,与居住在北部地区的妇女相比,居住在布隆阿哈福地区的妇女[优势比(AOR)=0.38,95%置信区间(CI)=0.17-0.84]不太可能在家分娩。在最贫困的五分之一财富群体中,在家分娩的可能性较高[AOR=2.02,95%CI=1.06-3.86],信奉其他宗教的妇女[AOR=3.45;95%CI=1.53-7.81],以及没有产前护理就诊的妇女[AOR=7.17;95%CI=1.64-31.3]。相反,与没有接受过正规教育的妇女相比,接受过中等/高等教育的妇女[AOR=0.30;95%CI=0.17-0.53]在家分娩的可能性较低。
本研究确定了居住地、财富五分位数、宗教信仰、产前护理就诊情况和教育水平是与加纳城市居民在家分娩相关的因素。因此,针对在家分娩的健康促进计划需要关注这些因素。我们还建议进行一项定性研究,以调查导致地区间在家分娩差异的因素,因为本研究无法进行这方面的调查。