ArticlePLOS global public health2024
A multilevel analysis of the predictors of health facility delivery in Ghana: Evidence from the 2014 Demographic and Health Survey.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Factors influencing clinical decision-making skills among nurses in Malaysia: A three-level general linear mixed-effects analysis.International journal of nursing studies advances · 2026Article
- Impact of eight or more antenatal care visits on intermittent preventive treatment of malaria uptake during pregnancy and facility-based delivery in Ghana: a propensity score matched analysis.BMC pregnancy and childbirth · 2026Article
- Spatial variation and hierarchical analysis of institutional delivery dropout after antenatal care contacts in Nigeria: findings from 3-survey rounds.Scientific reports · 2026Article
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Authors and funding
4 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Health facility delivery has the potential to improve birth and general health outcomes for both newborns and mothers. Regrettably, not all mothers, especially in low-and-middle income countries like Ghana deliver at health facilities, and mostly under unhygienic conditions. Using data from the 2014 Ghana Demographic and Health Survey, we fitted both weighted single-level and random intercept multilevel binary logistic regression models to analyse predictors of a health facility delivery among mothers aged 15-49 years and to quantify unobserved household and community differences in the likelihood of health facility delivery. We analysed data on 4202 mothers residing in 3936 households and 427 communities. Of the 4202 mothers who delivered, 3031 (75.3%-weighted and 72.1%-unweighted) delivered at the health facility. Substantial unobserved household only (Median Odds Ratio (MOR) = 5.1) and household conditional on community (MOR = 4.7) level differences in the likelihood of health facility delivery were found. Mothers aged 25-34 (aOR = 1.4, 95%CI: 1.0-2.1) and 35-44 (aOR = 2.9, 95%CI: 1.7-4.8), mothers with at least a secondary education (aOR = 2.7, 95%CI: 1.7-4.1), with health insurance coverage (aOR = 1.6, 95%CI: 1.2-2.2) and from richer/richest households (aOR = 8.3, 95%CI: 3.6-19.1) and with piped water (aOR = 1.5, 95%CI: 1.1-2.1) had increased odds of health facility delivery. Mothers residing in rural areas (aOR = 0.3, 95%CI: 0.2-0.5) and with no religion (aOR = 0.5, 95%CI: 0.3-1.0) and traditional religion (aOR = 0.2, 95%CI: 0.1-0.6), who reported not wanting to go to health facilities alone as a big problem (aOR = 0.5, 95%CI: 0.3-0.8) and having a parity of 2 (aOR = 0.4, 95%CI: 0.3-0.7), 3 (aOR = 0.3, 95%CI: 0.2-0.6) and ≥4 (aOR = 0.3, 95%CI: 0.1-0.5) had reduced odds of health facility delivery. Our predictive model showed outstanding predictive power of 96%. The study highlights the need for improved healthcare seeking behaviours, maternal education and household wealth, and bridge the urban-rural gaps to improve maternal and newborn health outcomes.
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Registered trials
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