Ghana Health Service HQ (PPMED), PMB Ministries, Accra, Ghana.
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BMC Pregnancy Childbirth. 2021 Dec 31;21(1):850. doi: 10.1186/s12884-021-04290-7.
Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana.
Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15-49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities.
The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother's health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women.
This study confirms that a mother's socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.
在分娩时获得熟练的接生服务是至关重要的，这对于将全球产妇死亡率降低到每 10 万 70 例以下，以实现到 2030 年可持续发展目标（SDGs）至关重要。尽管在加纳已经实施了几项减少产妇死亡率的举措，但在不同社会经济群体的妇女中，在分娩时获得熟练接生服务方面仍然存在不平等现象。本研究评估了加纳在分娩时获得和使用熟练接生服务方面的社会经济不平等情况。
研究通过文献综述和文件综述进行，并对 2014 年加纳人口与健康调查（GDHS）的二次数据分析，该调查是一项具有全国代表性的调查。共分析了 1305 名年龄在 15-49 岁之间的妇女，她们在调查前一年有过活产，并在熟练的接生员在场的情况下接受了调查。使用集中指数和曲线对这些妇女进行了分析。进一步对这些指数进行了分解，以确定导致不平等的主要社会经济因素。
结果发现，来自富裕家庭的妇女更容易获得熟练的接生员，这表明利用情况有利于富裕家庭。分解分析显示，家庭财富指数、母亲和丈夫/伴侣的教育水平、居住地区以及母亲的医疗保险覆盖范围是导致加纳妇女在分娩时获得熟练接生员方面存在社会经济不平等的主要因素。
本研究证实，母亲的社会经济地位对于降低产妇死亡率至关重要。因此，值得关注政策干预措施，以减少研究中发现的不平等现象。
