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        <identifier>oai:jicari.repo.nii.ac.jp:00000938</identifier>
        <datestamp>2023-05-15T13:11:07Z</datestamp>
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          <dc:title>Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study</dc:title>
          <dc:title xml:lang="en">Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study</dc:title>
          <jpcoar:creator>
            <jpcoar:creatorName xml:lang="en">Akpe Kwesi Enuameh, Yeetey</jpcoar:creatorName>
          </jpcoar:creator>
          <datacite:description descriptionType="Abstract">Background
Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan
African countries. Both maternal and neonatal health outcomes improve when skilled personnel
provide delivery services within health facilities. Determinants of delivery location
are crucial to promoting health facility deliveries, but little research has been done on this
issue in Ghana. This study explored factors influencing delivery location in predominantly
rural communities in Ghana.
Methods
Data were collected from 1,500 women aged 15–49 years with live or stillbirths that
occurred between January 2011 and April 2013. This was done within the three sites operating
Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra
Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health
Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants
of delivery location, controlling for covariates that were statistically significant in univariable
regression models.
Results
Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their
delivery location. After adjusting for confounders, the following factors were associated with
health facility delivery across all three sites: healthcare provider’s influence on deciding
health facility delivery, (AOR = 13.47; 95% CI 5.96–30.48), place of residence (AOR = 4.49;
95% CI 1.14–17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI
1.29–2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI
1.43–5.60).
Conclusion
In addition to known factors such as place of residence, socio-economic status, and possession
of valid health insurance, this study identified one more factor associated with
health facility delivery: healthcare provider’s influence. Ensuring care provider’s counseling
of clients could improve the uptake of health facility delivery in rural communities in Ghana.</datacite:description>
          <dc:publisher>PLoS ONE</dc:publisher>
          <datacite:date dateType="Issued">2016-03-31</datacite:date>
          <dc:language>eng</dc:language>
          <dc:type rdf:resource="http://purl.org/coar/resource_type/c_6501">journal article</dc:type>
          <jpcoar:identifier identifierType="HDL">http://hdl.handle.net/10685/00000928</jpcoar:identifier>
          <jpcoar:identifier identifierType="URI">https://jicari.repo.nii.ac.jp/records/938</jpcoar:identifier>
          <jpcoar:relation>
            <jpcoar:relatedIdentifier identifierType="DOI">10.1371/journal.pone.0152235</jpcoar:relatedIdentifier>
          </jpcoar:relation>
          <jpcoar:sourceTitle>PLoS ONE</jpcoar:sourceTitle>
          <jpcoar:sourceTitle xml:lang="en">PLoS ONE</jpcoar:sourceTitle>
          <jpcoar:pageStart>1</jpcoar:pageStart>
          <jpcoar:pageEnd>16</jpcoar:pageEnd>
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            <jpcoar:extent>387.3 kB</jpcoar:extent>
            <datacite:date dateType="Available">2018-06-14</datacite:date>
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