Low utilization of skilled delivery services in rural sub-Saharan Africa: a case for facility delivery improvement.

Maternal mortality remains a pressing global challenge, with sub-Saharan Africa (SSA) disproportionately affected. Despite efforts to improve access to skilled delivery services, utilization remains low, especially in rural areas. This paper synthesizes the extant literature and empirical evidence from rural Ghana to highlight the critical issue of low-skilled delivery services uptake in rural SSA. The literature review findings reveal a pooled prevalence of 54.9% skilled delivery services utilization, while the empirical survey in Ghana indicates a lower rate of 48.7%. These findings underscore the urgent need for targeted interventions to improve access to skilled delivery services in rural SSA. We recommend addressing harmful gender norms, evaluating existing interventions, and integrating qualitative and quantitative approaches to better understand barriers to skilled delivery services utilization in rural Africa. Urgent action is needed to ensure safer childbirth experiences and better maternal and child health outcomes in the region.