The relationship between perceived service quality of antenatal care and use among rural women in Ghana

Purpose: The purpose of this paper was to examine rural women’s perceived quality of antenatal care (ANC) and its influence on the extent of ANC in the Amansie Central District in the Ashanti Region of Ghana. Design/methodology/approach: A quantitative cross-sectional study was conducted with 120 women attending postnatal care at selected public health facilities. Structured interviews were used to obtain data. Crude odds ratio with 95% confidence interval (CI) was generated to determine the odds of women’s utilisation of ANC with their perceived service quality. The association between women’s background characteristics and ANC use was determined and assessed using Pearson’s χ² (2) test. Findings: Majority of the women (58.3 percent) utilised ANC for at least four times during pregnancy. Women’s education (p=0.027), religious affiliation (p=0.006), source of income (p=0.012) and insurance status (p=0.023) all had a positive relationship with ANC use. Women who perceived ANC quality as good were three times more likely to have four or more ANC visits than those who perceived quality as poor (OR= 3.042, 95% CI=0.181–0.647, p=0.001). Originality/value: Ghana has had numerous policy interventions that address the accessibility and quality of ANC service. However, little is known about the extent to which they are observed and about the quality of service from users’ perspective. Most existing literature on ANC use in Ghana focusses on socio-economic factors that influence utilisation. This paper will be the first to examine the perceived quality of ANC provided, and its influence on the extent of ANC visits among rural women in Ghana.