Factors Influencing Continuum of Care for Maternal and Child Health Among Young Mothers in Three Geographical Zones of Ghana: A Cross-Sectional Study

Presenter: Vida Ami Kukula, Dodowa Health Research Centre, Ghana Health Service

Background: Completion of continuum of care (CoC) for maternal and child health services (MNCH) is critical for reducing maternal morbidity and mortality and improving neonatal and child outcomes. We examined the CoC completion rate and factors associated with CoC completion among young mothers aged 15-24 years in Ghana.

Methods: We used data from a cross sectional study of 1500 mothers aged 15-49 years, with a history of live or stillbirth within the preceding two years, collected between July and September 2013. A 2-stage random sampling strategy was employed. We focused on young mothers aged 15-24 years (n=506). Components of MNCH including 4 or more antenatal care (ANC) visits, skilled/health facility delivery, and three postnatal visits (within 48 hours, at 2 and 6 weeks), were used to determine CoC completion. For descriptive analyses, the chi square test and ANOVA were used to identify variables affecting CoC completion. Bivariate and multivariate logistic regression analyses were performed to confirm the observed associations using STATA 12.0.

Results: Only 9.5% of the mothers completed CoC. Of these, 84.4% received at least 4 ANC consultations, 74.0% had skilled delivery care, 27.3% had PNC within 48 hours, 53.5% and 90.4% had PNC at 2 and 6 weeks respectively. Young mothers in the northern zone were more likely to complete CoC than those in the coastal zone (odds ratio [OR]=2.05, 95% confidence interval [CI]: 1.04-4.05). Educational status of the mother, marital status, duration of marriage, planned/unplanned pregnancy, and age of partner were associated with CoC. In univariate analysis, 1-2 years of marriage was associated with CoC completion. In the multivariate model, ‘wanting to get pregnant later’ was associated with CoC completion.

Conclusion: Young mothers showed poor CoC completion across Ghana. Interventions must aim at increasing awareness about CoC completion.