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Online Program

334036
Dual analysis of the continuum of care in maternal, neonatal, and child health in Ghana


Monday, November 2, 2015

Akira Shibanuma, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
Francis Yeji, Navrongo Health Research Centre, Navrongo, Ghana
Sumiyo Okawa, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
Emmanuel Mahama, Kintampo Health Research Centre, Brong-Ahafo Region, Ghana
Kimiyo Kikuchi, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
Clement Tetteh Narh, School of Public Health, University of Health and Allied Sciences, Volta Region, Ghana
Yeetey Enuameh, Kintampo Health Research Centre, Brong-Ahafo Region, Ghana
Keiko Nanishi, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
Evelyn Ansah, Research and Development Division, Ghana Health Service, Accra, Ghana
Abraham Hodgson, Research and Development Division, Ghana Health Service, Accra, Ghana
Masamine Jimba, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
Background:Continuum of care (CoC) has recently received attention in maternal, neonatal, and child health. However, a community-based measurement of CoC is not available. Throughout the pregnancy, delivery, and post-delivery stages, this study assessed CoC based on two definitions: continuous visits to health facilities (Definition 1) and receiving key components of services (Definition 2). This study also identified differences between the two definitions on the predictors and the likelihood of achievement across areas.

Methods: Continuum of care and other characteristics of 1,401 pairs of randomly selected women and infants were collected in 2013 under a retrospective cross-sectional survey in Ghana. Multilevel logistic regression was used to estimate the factors associated with CoC and its divergence across areas.

Results: Of all, 7.9% and 12.2% of women and infants achieved CoC under Definitions 1 and 2, respectively. Those who were from one standard deviation richer household were around 1.5 times more likely to achieve it under both definitions (95% CI: 1.1-2.1 for Definition 1; 1.1-1.9 for Definition 2). Younger and uneducated women were less likely to achieve it under Definition 2 only. Area-level variance in CoC was more than four times larger under Definition 2 than Definition 1.

Conclusions: Most women and infants failed to achieve the continuum of care in maternal, neonatal, and child health in Ghana. This dual analysis revealed that those who consistently visited health facilities did not necessarily receive key components of services. Inequity in the provision of services should be addressed both from the supply and demand sides.

Learning Areas:

Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Compare two community-level measurements of continuum of care from the pregnancy to post-delivery stages; 1) continuous visits to health facilities and 2) receiving key components of services during visits. Assess how divergent the achievement of continuum of care is among different local areas.

Keyword(s): Health Care Access, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a researcher in community health and development economics, I have been involved in a number of research projects that focus on behaviors among people regarding their seeking health services and adopting good knowledge and practices. One of my key research interests is inequity and inequality in accessing to community health services, including maternal, neonatal, and child health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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