Determinants of Quality Antenatal Care in a Peri-Urban Hospital, Ghana: An Application of the Content and Timing of Care in Pregnancy (CTP) Tool

Aims: To assess the quality of antenatal care and determine factors influencing access to quality care at the Holy Family Hospital, Nkawkaw in the Kwahu West Municipality of Ghana.

Study Design: A facility-based cross-sectional study.

Place and Duration of Study: Postnatal clinic of Holy Family Hospital, Nkawkaw, from July to September 2016.

Methodology: Four hundred postnatal clinic attendants age 15-49 years were selected consecutively for the study. Quality of antenatal care was classified according to the Content and Timing of care in Pregnancy (CTP) tool developed by Beekman et al (2011). Logistic regression was used to determine predictors of acceptable quality care. Results were presented as adjusted odds ratio at 95% confidence level.

Results: Approximately 66% of respondents received acceptable quality of care. Being a trader (AOR=4.1, 95%CI: 1.7-10.0); having had three or four births (AOR=2.0, 95%CI: 1.1-3.6) and having a partner with secondary education (AOR=4.6, 95%CI: 1.9-11.0) were significantly associated with receiving acceptable quality of care.

Conclusion: Although 66% of the respondents accessed acceptable quality of care, the hospital has the capacity to provide quality care to all women attending its antenatal clinic. Community-based Health Planning and Services; mobile phone text messaging to remind pregnant women of appointments; and domiciliary midwifery services could be part of effective strategies to address gaps in quality antenatal care.