Utilization and Quality of Antenatal Care Services Among Women in Ghana

Abstract

Background: Despite progress in maternal healthcare, antenatal care (ANC) utilization and quality remain suboptimal in many low- and middle-income countries, including Ghana. The World Health Organization (WHO) updated its ANC guidelines in 2016 to recommend a minimum of eight contacts during pregnancy, aiming to improve maternal and neonatal health outcomes. However, data from the 2022 Ghana Demographic and Health Survey (GDHS) indicate that while most women attend at least one ANC visit, only about 38.4% meet the eight-contact benchmark. Persistent disparities exist, influenced by factors such as age, education, wealth, geographic location, and health system limitations. Understanding these dynamics is essential to achieving national and global maternal health targets. Aim: This study aims to assess the utilization and quality of ANC services among women of reproductive age in Ghana, using data from the 2022 GDHS. Method: A quantitative, cross-sectional design was employed using secondary data from the GDHS 2022. The study population included women aged 15–49 who had a live birth within five years prior to the survey. Descriptive statistics were used to summarize ANC utilization, while chi-square tests and logistic regression models identified key predictors of ANC adequacy and quality. Results: The analysis included 5,036 women aged 15–49 years with recent births in Ghana. Antenatal care (ANC) utilization was near-universal (98%). While 88.58% of women achieved at least four ANC visits, only 38.75% met the updated WHO recommendation of eight or more visits. Early initiation of ANC was common, with 64.78% of women beginning care within the first trimester; however, 35.22% initiated care later than recommended. At the bivariate level, age, education, household wealth, place of residence, and parity were associated with achieving eight or more ANC visits. In adjusted analyses, age, wealth, and parity remained significant predictors of adequate ANC utilization. viii Conclusion: Although antenatal care coverage in Ghana is high, achieving recommended standards of care remains uneven. Targeted efforts to improve early initiation and completion of adequate ANC visits, particularly among younger, poorer, and higher-parity women, are essential to promote equity and maternal health outcomes.