Utilization Of Skilled Delivery Services In Wa Municipality

ABSTRACT Introduction Labour and delivery are the shortest and most critical period during pregnancy and childbirth because most maternal deaths arise from complications during delivery. In subSaharan Africa skilled delivery coverage is about 46.5%. In Ghana skilled delivery was 45.6% in 2009 and 73 % in 2014 and that of Upper West Region was 53% in 2011 and 63.7% in 2014. This study assessed the factors that account for the low utilization of skilled delivery by pregnant women in the Wa Municipality. Methods A community based cross sectional study was conducted using structured questionnaire to collect information from respondents on socio-demographic, geographic and cultural factors that affect the utilization of skilled delivery services. The study involved women of reproductive age (15- 49 years) who delivered within one year prior to the study. Two urban sub-districts and two rural sub-districts were selected using simple stratified random sampling method. Four communities were selected from each sub-district by simple randon sampling. Thirty-three eligible women were interviewed at each community. The data were entered into SPSS 16 cleaned and exported to Stata 13 for analysis. We used univariate analysis to generate descriptive tabulations for key variables. Bivariate analysis and logistic regression modelling produced unadjusted and adjusted associations between backgrounds attributes of respondents and their uptake of skilled delivery services. Results Out of 528 mothers 481 (91.6%) had skilled delivery. Mean age of mother was 26 years. Factors that were significantly associated with skilled delivery were, urban residence (AOR= 0.4, 95%), CI 0.1-1.2), women autonomy (AOR=0.2 95% CI 0.1-0.6), time taken  to get to health facility (distance) (AOR=0.08, 95% CI 0.1-0.3), ANC attendance {AOR=0.01, 95% CI, (0.01-0.1)}, where to deliver (AOR=59.8 95% CI 1.6-2122.8), and Trading occupation (AOR= 5.1, 95% CI 1.4-18.4). Conclusion The findings of this study demonstrate adequate utilization of skilled delivery services among women in the Municipality. The major factors identified as capable of influencing the utilization of skilled delivery services are women’s education, place of residence, women’s autonomy and proximity to health facility. The study also revealed a higher proportion of skilled delivery in urban settlement than in rural areas. Efforts toward improvement of skilled delivery coverage should focus on health education and a girl child education especially for rural women and expansion of community-based health planning and services in various communities.