Le SIDA au Ghana (serveur d'exploration)

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What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

Identifieur interne : 000A68 ( Ncbi/Merge ); précédent : 000A67; suivant : 000A69

What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

Auteurs : Kwamena Sekyi Dickson [Ghana] ; Kenneth Setorwu Adde [Ghana] ; Hubert Amu [Ghana]

Source :

RBID : PMC:5215620

Abstract

Background. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner's education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women. Conclusions. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner's education, parity, and distance in their planning regarding delivery care in rural Ghana.


Url:
DOI: 10.1155/2016/7203980
PubMed: 28101522
PubMed Central: 5215620

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PMC:5215620

Le document en format XML

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<italic>Background</italic>
. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country.
<italic> Methods</italic>
. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data.
<italic> Results</italic>
. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner's education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women.
<italic> Conclusions</italic>
. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner's education, parity, and distance in their planning regarding delivery care in rural Ghana.</p>
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<given-names>Kwamena Sekyi</given-names>
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<sup>*</sup>
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</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-0218-3843</contrib-id>
<name>
<surname>Amu</surname>
<given-names>Hubert</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
</contrib-group>
<aff id="I1">Department of Population and Health, University of Cape Coast, Cape Coast, Ghana</aff>
<author-notes>
<corresp id="cor1">*Kwamena Sekyi Dickson:
<email>nadicx@gmail.com</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Hind A. Beydoun</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>22</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>7203980</elocation-id>
<history>
<date date-type="received">
<day>2</day>
<month>10</month>
<year>2016</year>
</date>
<date date-type="rev-recd">
<day>21</day>
<month>11</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>4</day>
<month>12</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2016 Kwamena Sekyi Dickson et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>
<italic>Background</italic>
. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country.
<italic> Methods</italic>
. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data.
<italic> Results</italic>
. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner's education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women.
<italic> Conclusions</italic>
. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner's education, parity, and distance in their planning regarding delivery care in rural Ghana.</p>
</abstract>
</article-meta>
</front>
<floats-group>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Background characteristics and place of delivery.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th rowspan="3" align="left" colspan="1">Variable </th>
<th colspan="2" align="center" rowspan="1">Place of delivery</th>
<th rowspan="3" align="center" colspan="1">
<italic>P</italic>
value</th>
</tr>
<tr>
<th align="center" rowspan="1" colspan="1">Home</th>
<th align="center" rowspan="1" colspan="1">Facility</th>
</tr>
<tr>
<th align="center" rowspan="1" colspan="1">
<italic>N</italic>
= 906 (100%)</th>
<th align="center" rowspan="1" colspan="1">
<italic>N</italic>
= 1372 (100%)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Maternal age</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.107</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">15–19</td>
<td align="center" rowspan="1" colspan="1">23 (38.0%)</td>
<td align="center" rowspan="1" colspan="1">38 (62.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">20–24</td>
<td align="center" rowspan="1" colspan="1">153 (40.0%)</td>
<td align="center" rowspan="1" colspan="1">228 (60.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">25–29</td>
<td align="center" rowspan="1" colspan="1">206 (36.4%)</td>
<td align="center" rowspan="1" colspan="1">360 (63.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">30–34</td>
<td align="center" rowspan="1" colspan="1">223 (45.5%)</td>
<td align="center" rowspan="1" colspan="1">267 (54.5%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">35–39</td>
<td align="center" rowspan="1" colspan="1">165 (38.4%)</td>
<td align="center" rowspan="1" colspan="1">288 (63.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">40–44</td>
<td align="center" rowspan="1" colspan="1">93 (38.6%)</td>
<td align="center" rowspan="1" colspan="1">148 (61.4%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">45–49</td>
<td align="center" rowspan="1" colspan="1">45 (51.2%)</td>
<td align="center" rowspan="1" colspan="1">43 (48.8%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Wealth index</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Poorest</td>
<td align="center" rowspan="1" colspan="1">452 (53.7%)</td>
<td align="center" rowspan="1" colspan="1">389 (46.3%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Poorer</td>
<td align="center" rowspan="1" colspan="1">301 (41.9%)</td>
<td align="center" rowspan="1" colspan="1">418 (58.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Middle</td>
<td align="center" rowspan="1" colspan="1">138 (29.7%)</td>
<td align="center" rowspan="1" colspan="1">327 (70.3%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Richer</td>
<td align="center" rowspan="1" colspan="1">13 (5.9%)</td>
<td align="center" rowspan="1" colspan="1">207 (94.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Richest</td>
<td align="center" rowspan="1" colspan="1">3 (8.4%)</td>
<td align="center" rowspan="1" colspan="1">31 (91.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Educational level</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No education</td>
<td align="center" rowspan="1" colspan="1">468 (53.4%)</td>
<td align="center" rowspan="1" colspan="1">409 (46.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Primary</td>
<td align="center" rowspan="1" colspan="1">213 (41.1%)</td>
<td align="center" rowspan="1" colspan="1">305 (58.9%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Secondary</td>
<td align="center" rowspan="1" colspan="1">223 (26.4%)</td>
<td align="center" rowspan="1" colspan="1">620 (73.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Higher</td>
<td align="center" rowspan="1" colspan="1">3 (6.9%)</td>
<td align="center" rowspan="1" colspan="1">38 (93.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ecological zone </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Coastal zone</td>
<td align="center" rowspan="1" colspan="1">302 (34.7%)</td>
<td align="center" rowspan="1" colspan="1">569 (65.3%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Forest zone</td>
<td align="center" rowspan="1" colspan="1">256 (34.4%)</td>
<td align="center" rowspan="1" colspan="1">490 (65.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Savannah zone</td>
<td align="center" rowspan="1" colspan="1">348 (52.7%)</td>
<td align="center" rowspan="1" colspan="1">313 (47.3%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Getting money needed for treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Big problem</td>
<td align="center" rowspan="1" colspan="1">531 (46.0%)</td>
<td align="center" rowspan="1" colspan="1">623 (54.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not a big problem</td>
<td align="center" rowspan="1" colspan="1">375 (33.4%)</td>
<td align="center" rowspan="1" colspan="1">749 (66.6%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ethnicity </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Akan</td>
<td align="center" rowspan="1" colspan="1">296 (31.0%)</td>
<td align="center" rowspan="1" colspan="1">659 (69.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ga/Dangme</td>
<td align="center" rowspan="1" colspan="1">38 (43.0%)</td>
<td align="center" rowspan="1" colspan="1">52 (57.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ewe</td>
<td align="center" rowspan="1" colspan="1">104 (37.6%)</td>
<td align="center" rowspan="1" colspan="1">172 (62.4%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Guan</td>
<td align="center" rowspan="1" colspan="1">16 (34.3%)</td>
<td align="center" rowspan="1" colspan="1">30 (65.7%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mole–Dagbani</td>
<td align="center" rowspan="1" colspan="1">181 (37.8%)</td>
<td align="center" rowspan="1" colspan="1">297 (62.2%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Grusi</td>
<td align="center" rowspan="1" colspan="1">28 (37.9%)</td>
<td align="center" rowspan="1" colspan="1">46 (62.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Gurma</td>
<td align="center" rowspan="1" colspan="1">217 (73.9%)</td>
<td align="center" rowspan="1" colspan="1">77 (26.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mande</td>
<td align="center" rowspan="1" colspan="1">5 (15.9%)</td>
<td align="center" rowspan="1" colspan="1">27 (84.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Other</td>
<td align="center" rowspan="1" colspan="1">21 (66.8%)</td>
<td align="center" rowspan="1" colspan="1">10 (33.2%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Parity </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">One birth</td>
<td align="center" rowspan="1" colspan="1">90 (27.5%)</td>
<td align="center" rowspan="1" colspan="1">238 (72.5%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Two births</td>
<td align="center" rowspan="1" colspan="1">139 (36.6%)</td>
<td align="center" rowspan="1" colspan="1">240 (63.4%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Three births</td>
<td align="center" rowspan="1" colspan="1">146 (34.9%)</td>
<td align="center" rowspan="1" colspan="1">273 (65.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Four births or more</td>
<td align="center" rowspan="1" colspan="1">531 (46.1%)</td>
<td align="center" rowspan="1" colspan="1">621 (53.9%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Partner's education </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No education</td>
<td align="center" rowspan="1" colspan="1">396 (56.0%)</td>
<td align="center" rowspan="1" colspan="1">311 (44.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Primary</td>
<td align="center" rowspan="1" colspan="1">129 (40.9%)</td>
<td align="center" rowspan="1" colspan="1">187 (59.1%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Secondary</td>
<td align="center" rowspan="1" colspan="1">361 (32.0%)</td>
<td align="center" rowspan="1" colspan="1">767 (68.0%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Higher</td>
<td align="center" rowspan="1" colspan="1">20 (15.8%)</td>
<td align="center" rowspan="1" colspan="1">106 (84.3%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Distance to health facility</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">0.000</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Big problem</td>
<td align="center" rowspan="1" colspan="1">422 (51.8%)</td>
<td align="center" rowspan="1" colspan="1">392 (48.2%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not a big problem</td>
<td align="center" rowspan="1" colspan="1">485 (33.1%)</td>
<td align="center" rowspan="1" colspan="1">979 (66.9%)</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float">
<label>Table 2</label>
<caption>
<p>Binary logistic regression on place of delivery among women in Ghana.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Independent variable</th>
<th align="center" rowspan="1" colspan="1">Odds ratio</th>
<th align="center" rowspan="1" colspan="1">95% confidence interval</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Educational level</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No education</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Primary</td>
<td align="center" rowspan="1" colspan="1">1.30
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.01–1.67</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Secondary</td>
<td align="center" rowspan="1" colspan="1">1.84
<sup>
<italic>∗∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.40–2.42</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Higher</td>
<td align="center" rowspan="1" colspan="1">5.94
<sup>
<italic></italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">0.73–48.06</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Wealth index</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Poorest</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Poorer</td>
<td align="center" rowspan="1" colspan="1">1.16</td>
<td align="center" rowspan="1" colspan="1">0.90–1.49</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Middle</td>
<td align="center" rowspan="1" colspan="1">1.60
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.14–2.23</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Richer</td>
<td align="center" rowspan="1" colspan="1">4.72
<sup>
<italic>∗∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">2.42–9.21</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Richest</td>
<td align="center" rowspan="1" colspan="1">3.28</td>
<td align="center" rowspan="1" colspan="1">0.38–28.27</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Parity </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">One birth</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Two births</td>
<td align="center" rowspan="1" colspan="1">0.82</td>
<td align="center" rowspan="1" colspan="1">0.57–1.16</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Three births</td>
<td align="center" rowspan="1" colspan="1">0.79</td>
<td align="center" rowspan="1" colspan="1">0.56–1.12</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Four births or more</td>
<td align="center" rowspan="1" colspan="1">0.66
<sup>
<italic>∗∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">0.49–0.90</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Partner's education </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No education</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Primary</td>
<td align="center" rowspan="1" colspan="1">1.50
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.13–2.01</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Secondary</td>
<td align="center" rowspan="1" colspan="1">1.54
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.18–2.01</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Higher</td>
<td align="center" rowspan="1" colspan="1">2.14
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.15–3.98</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Distance to health facility</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Big problem</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not a big problem</td>
<td align="center" rowspan="1" colspan="1">1.56
<sup>
<italic>∗∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.27–1.93</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Getting money need for treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Big problem</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not a big problem</td>
<td align="center" rowspan="1" colspan="1">1.00</td>
<td align="center" rowspan="1" colspan="1">0.80–1.23</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ecological zone </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Coastal zone</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Forest zone</td>
<td align="center" rowspan="1" colspan="1">1.34
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.04–1.72</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Savannah zone</td>
<td align="center" rowspan="1" colspan="1">1.37
<sup>
<italic></italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">0.95–1.97</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ethnicity </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Akan</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
<td align="center" rowspan="1" colspan="1">Ref</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ga/Dangme</td>
<td align="center" rowspan="1" colspan="1">0.80</td>
<td align="center" rowspan="1" colspan="1">0.47–1.34</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ewe</td>
<td align="center" rowspan="1" colspan="1">1.03</td>
<td align="center" rowspan="1" colspan="1">0.74–1.43</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Guan</td>
<td align="center" rowspan="1" colspan="1">1.37</td>
<td align="center" rowspan="1" colspan="1">0.73–2.59</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mole–Dagbani</td>
<td align="center" rowspan="1" colspan="1">1.79
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.23–2.59</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Grusi</td>
<td align="center" rowspan="1" colspan="1">1.47</td>
<td align="center" rowspan="1" colspan="1">0.89–2.40</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Gurma</td>
<td align="center" rowspan="1" colspan="1">0.47
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">0.31–0.71</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mande</td>
<td align="center" rowspan="1" colspan="1">3.15
<sup>
<italic>∗∗</italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">1.33–7.46</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Other</td>
<td align="center" rowspan="1" colspan="1">0.44
<sup>
<italic></italic>
</sup>
</td>
<td align="center" rowspan="1" colspan="1">0.19–1.03</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Ref = Reference.
<sup>
<italic></italic>
</sup>
<italic>P</italic>
< 0.05;  
<sup>
<italic>∗∗</italic>
</sup>
<italic>P</italic>
< 0.01;  
<sup>
<italic>∗∗∗</italic>
</sup>
<italic>P</italic>
< 0.001.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Ghana</li>
</country>
</list>
<tree>
<country name="Ghana">
<noRegion>
<name sortKey="Dickson, Kwamena Sekyi" sort="Dickson, Kwamena Sekyi" uniqKey="Dickson K" first="Kwamena Sekyi" last="Dickson">Kwamena Sekyi Dickson</name>
</noRegion>
<name sortKey="Adde, Kenneth Setorwu" sort="Adde, Kenneth Setorwu" uniqKey="Adde K" first="Kenneth Setorwu" last="Adde">Kenneth Setorwu Adde</name>
<name sortKey="Amu, Hubert" sort="Amu, Hubert" uniqKey="Amu H" first="Hubert" last="Amu">Hubert Amu</name>
</country>
</tree>
</affiliations>
</record>

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