Quality of antenatal care and outcomes of Hypertensive Disorders in Pregnancy among antenatal attendees: A comparison of urban and periurban health facilities in Ghana

Pauline Boachie-Ansah; Berko Panyin Anto; Afia Frimpomaa Asare Marfo; Edward Tieru Dassah; Ivan Eduku Mozu; Joseph Attakora

doi:10.1371/journal.pone.0294327

Quality of antenatal care and outcomes of Hypertensive Disorders in Pregnancy among antenatal attendees: A comparison of urban and periurban health facilities in Ghana

PLoS One. 2023 Dec 1;18(12):e0294327. doi: 10.1371/journal.pone.0294327. eCollection 2023.

Authors

Pauline Boachie-Ansah¹, Berko Panyin Anto¹, Afia Frimpomaa Asare Marfo¹, Edward Tieru Dassah^{2

3}, Ivan Eduku Mozu¹, Joseph Attakora^{1

4}

Affiliations

¹ Faculty of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
² Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
³ Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁴ Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Abstract

Rural-urban-peri urban disparity assessments on health outcomes have been considered as critical determinants of health and health service outcomes. It is policy relevant in terms of the burden of disease and also provides focus on target interventions. This study aimed to assess the differences in the quality of Ante-natal Care (ANC) and the outcomes of Hypertensive Disorders in Pregnancy (HDPs) from selected health facilities in Ghana. This was a questionnaire-based cross-sectional study. Data on demographics, proportions of HDPs, quality of ANC and the outcomes of HDPs were collected. Logistic regression models were used to examine the association of the independent variables with the location of the health of facility. A total of 500 pregnant women were included in this study. There were 270 (54%) urban and 230 (46%) peri-urban dwellers. The proportion of HDPs varied with the location of the health facility. Women attending urban health facilities were more likely to be hypertensive (μ2 = 126.4; p<0.001), have chronic hypertension with superimposed pre-eclampsia (p< 0.001), have good quality ANC (μ2 = 41.28; p< 0.001), deliver full term (μ2 = 4.83; p = 0.028), and have excellent knowledge on HDPs (μ2 = 227.65; p< 0.001) compared to women receiving care in peri-urban health facilities. The method of delivery and outcome of birth did not statistically vary amongst the periurban and urban health facilities. There was an increase in the proportion in preterm in urban compared to periurban. The burden of HDPs was high in urban health facilities with high proportion of its mothers receiving quality ANC as well as having excellent knowledge on HDPs compared to mothers receiving care at the periurban health facilities. There is a need to target maternal care interventions to the periurban health facilities to improve obstetric health outcomes.

Copyright: © 2023 Boachie-Ansah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Cross-Sectional Studies
Female
Ghana / epidemiology
Health Facilities
Humans
Hypertension, Pregnancy-Induced* / epidemiology
Hypertension, Pregnancy-Induced* / therapy
Infant, Newborn
Pregnancy
Prenatal Care* / methods

Grants and funding

PBA received a local scholarship from the Ghana National Petroleum Corporation (GNPC) Foundation, Ghana (GNPC/FDN/C4/KNUST/18) Sponsors played no role in the study design or manuscript www.gnpcghana.com/scholarship.html The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.