Antenatal Care and Delivery Services Utilisation Among Women Aged 15–49 Years in Ada West District, Greater Accra Region, Ghana

Abstract

Background: Despite progress in maternal healthcare in Ghana, maternal mortality remains a significant public health concern, particularly in underserved districts. In the Ada West District of the Greater Accra Region, limited research exists on ANC and delivery services utilisation and what factors shape their healthcare behaviours. Improving maternal health outcomes requires a context-specific understanding of the barriers that women face during pregnancy and childbirth. General Objective: This study examined ANC and delivery service utilisation among women of reproductive age (15–49 years) in the Ada West District, Greater Accra Region, Ghana. Methods: This study adopted a cross-sectional quantitative design. Data was collected using structured questionnaires deployed via Kobo ToolBox and administered through face-to-face interviews with 362 women who have experienced pregnancy and childbirth within the past three years. Sampling involved a multi-stage approach, targeting participants from health facilities and community settings. Data were analysed using STATA version 18, employing descriptive statistics, bivariate tests, and multivariate logistic regression to identify significant predictors of ANC and delivery utilisation. Results: The study found a high antenatal care (ANC) utilisation rate of 95.0%, with 80.5% attending regularly and 91.0% completing adequate visits. However, 40.4% of women reported difficulties accessing ANC, primarily due to cost (60.1%). Facility delivery coverage was 81.2%, yet 18.8% of women delivered outside health facilities, predominantly at home (39.7%) or with Traditional Birth Attendants (30.9%). Conclusion: Despite high antenatal care coverage in the Ada West District, a significant gap remains in converting this contact into facility-based deliveries. The findings underscore that consistent, quality ANC and positive service perceptions are critical for promoting skilled delivery. Interventions must extend beyond encouraging ANC attendance to address financial barriers, reinforce birth preparedness during ANC, and target high-parity and less-educated women to bridge this gap and improve maternal and newborn outcome