Regional disparities and socio-demographic factors associated with eight or more antenatal care visits in Ghana.

Background: Antenatal care is vital for maternal health and wellbeing, with the World Health Organization recommending a minimum of eight visits during pregnancy. In this study, we examined the regional disparities and factors associated with eight or more antenatal care visits in Ghana.

Methods: We performed a cross-sectional analysis of data from the 2022 Ghana Demographic and Health Survey. Our study comprised 3,893 women of reproductive age with birth history in the last two years before the survey. Regional disparities in the proportion of eight or more antenatal care visits were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was conducted to determine the factors associated with eight or more antenatal care visits using a four-modeled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).

Results: The prevalence of eight or more antenatal care visits in Ghana was 38.4% [95% CI = 36.0-41.0]. The regions with the highest prevalence were Eastern, Greater Accra, Western, and Volta. Those with the lowest prevalence were Northern, North East, Savannah, and Oti. The odds of eight or more antenatal care visits were lower among women aged 40-49 [aOR = 0.42, 95% CI = 0.18-0.96], women with four or more children [aOR = 0.57, 95% CI = 0.36-0.93], women who wanted pregnancy later [aOR = 0.63, 95% CI = 0.46-0.85], and women in five regions: Western North [aOR = 0.43, 95% CI = 0.19-0.94], Bono [aOR = 0.33, 95% CI = 0.14-0.76], Northern [aOR = 0.29, 95% CI = 0.13-0.66], Savannah [aOR = 0.30, 95% CI = 0.14-0.65] and North East [aOR = 0.33, 95% CI = 0.14-0.75]. Women in the richer [aOR = 1.99, 95% CI = 1.19-3.33] and richest [aOR = 4.82, 95% CI = 2.45-9.51] wealth index showed a higher likelihood of completing eight or more antenatal care visits relative to women in the poorest wealth index.

Conclusion: A significant proportion of women in Ghana fall short of the recommended eight or more antenatal care visits. Age, parity, desired pregnancy timing, wealth status, and region of residence are associated with the number of antenatal care visits. Women in five regions (Bono, Northern, North East, Savannah, and Western North) are significantly less likely to have eight or more antenatal care visits than those in the Western region. The government and policymakers should design programs to address the needs of older women, those with high parity, and women who want to delay pregnancy. Increased healthcare resources, educational campaigns, and addressing regional barriers to antenatal care access are crucial. Promoting public health initiatives to emphasise the importance of completing the recommended number of antenatal care visits for a healthy pregnancy is essential.