Factors Associated with Unskilled Deliveries; Observations from the Obom Sub-Municipality, Ga South District, Ghana

Abstract

In times past, Traditional Birth Attendants (TBAs) have been the leading human resource for women during childbirth. In rural areas of developing countries, their role differs across cultures and at different times, but even today, they are present at the majority of deliveries. Trained birth attendants at delivery are vital for averting both maternal and new-born deaths. To improve maternal health and thus achieve the Millennium Development Goal (MDG 5), there is the need to assess the constraints to skilled delivery. Obom is one of the sub-municipal in the Ga South District, where women still deliver at home and without the assistance of trained birth attendants. This has necessitated the study to assess the practices of TBAs in determining the prevalence and factors that are associated with traditional birth deliveries in the sub-municipality within the Ga-South municipality in Ghana. This knowledge is important for the design of public health interventions promoting facility-based skilled birth attendance in Obom sub-municipality in the Ga South District. A cross sectional study was conducted on 380 women within the reproductive age of 15-49 who have delivered within two years and have resided in the community for the past two years prior to the study in 2017. Convenient sampling was used to select participants from three communities each from six functioning CHPS zones in the sub-municipal. Association between variables was determined using Fisher’s Exact Test. The findings showed that a majority of respondents 205 (53.95 %) delivered at home and 46.05% had skilled assistance at delivery. The Age of the woman, Age at first birth, Education level, Religious status, History of miscarriage, Child loss, Parity as well as Use of traditional medicine when child is sick showed statistical association with the utilization of TBAs. Reasons for not utilizing skilled delivery identified in the study include: abrupt delivery 31.71%, perception that health facility delivery is not necessary 19.02%, distance to facility too far 14.63% and too costly 18.54%, others include: unavailability of transportation, staff not available and not friendly when available. These challenges need to be addressed to improve skilled delivery services in the sub-municipality and the nation at large.