Educational attainment and HIV testing and counselling service utilisation during antenatal care in Ghana: Analysis of Demographic and Health Surveys

Francis Sambah; Linus Baatiema; Francis Appiah; Edward Kwabena Ameyaw; Eugene Budu; Bright Opoku Ahinkorah; Joseph Kojo Oduro; Abdul-Aziz Seidu

doi:10.1371/journal.pone.0227576

Educational attainment and HIV testing and counselling service utilisation during antenatal care in Ghana: Analysis of Demographic and Health Surveys

PLoS One. 2020 Jan 15;15(1):e0227576. doi: 10.1371/journal.pone.0227576. eCollection 2020.

Authors

Francis Sambah¹, Linus Baatiema², Francis Appiah², Edward Kwabena Ameyaw³, Eugene Budu², Bright Opoku Ahinkorah³, Joseph Kojo Oduro², Abdul-Aziz Seidu²

Affiliations

¹ Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana.
² Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
³ The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Abstract

Introduction: Receiving results for Human Immunodeficiency Virus (HIV) testing and counselling during antenatal care (ANC) is critical for eliminating mother-to-child transmission. We investigated the educational attainment of women and receiving results for HIV testing and counselling (HTC) during ANC in Ghana.

Materials and methods: We extracted data from the women's files of the 2008 and 2014 Ghana Demographic and Health Surveys. The study sampled 2,660 women aged 15-49 with complete data on receiving HIV testing results during ANC. We computed the highest educational attainment and receipt of HTC results for each of the surveys and presented it with a dot plot. Two Binary Logistic Regression Models were fitted to determine the likelihood of receiving HTC results by the educational attainment of the women.

Results: We found that receiving HTC results was highest among women with secondary or higher education (87.4% in 2008 and 89.5% in 2014) and least among those with no education (69.9% in 2008 and 76.8 in 2014). From the regression analysis, women with secondary or higher level of education [AOR = 1.535; CI = 1.044, 2.258], richest women [AOR = 5.565; CI = 2.560, 12.10], and women aged 30-34 years [AOR = 1.693; CI = 1.171, 2.952], were more likely to receive HTC results. However, those who did not know that a healthy-looking person can have HIV or not [AOR = 0.322; CI = 0.161, 0.646] were less likely to receive HTC results.

Conclusion: Despite the relatively high receipt of HTC results at ANC observed between 2008 and 2014, our findings revealed disparities driven by educational attainment, wealth status, age, ANC visits and residence. This indicates that women with no education, those from rural areas, younger and poor women are missing out on the full continuum of HTC service at ANC. The Health Promotion Unit of Ghana Health Service through Community Health Nurses and the Community-Based Health Planning and Services, should intensify their education programs on HIV and make full utilisation of HIV testing and counselling service appealing to women during ANC. This is particularly to be prioritised among the least educated, younger women and rural dwellers.

MeSH terms

Adolescent
Adult
Counseling / statistics & numerical data*
Demography / statistics & numerical data*
Educational Status*
Female
Ghana
HIV Infections / diagnosis*
Health Surveys*
Humans
Mass Screening / statistics & numerical data*
Middle Aged
Prenatal Care / statistics & numerical data*
Young Adult

Grants and funding

No funding was received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.