Page 109 - GHES-2-2

Global Health Econ Sustain Antenatal care attendance

pregnant women visiting Adidome Government Hospital and communities such as Mepe, Osudoku, Ada East
and Battor Catholic Hospital and (ii) to estimate ANC and West, Volo, Abutia, and Mafi-Adidome. Patients
attendance, IPTp-SP doses administered, and insecticide- visiting the facility are likely to pay a bit more for similar
treated mosquito net use at the two health centers. services compared to AGH. Other small clinics and CHPS
compounds are located within the North Tongu District.
2. Methods Pregnant women visiting these two health facilities for

2.1. Research question ANC and delivery from November 2016 to March 2019
were recruited after informed consent was obtained.
The central research question in this study is: “what is
the effect of the knowledge of ANC and malaria, IPTp, 2.3. Ethics approval and consent to participate
and mosquito bed net use among pregnant women from Ethical approval for the study was obtained in 2016 from
malaria-endemic communities on the attainment of SDG the Institutional Review Board of the Noguchi Memorial
3.1?” Institute for Medical Research (NMIMR-IRB CPN 071/15-

2.2. Study area and participant recruitment 16, amend. 2017) and the Ethical Review Committee of the
Ghana Health Service (GHS-ERC 06/06/16).
Mafi-Adidome (Central Tongu District capital) and Battor-
Dugame (North Tongu District capital) share a common The objectives of the study were explained to each
boundary; hence, there is movement of people, goods, participant in their language of choice, after which they
and services between them. Battor-Dugame has a densely were presented with a written consent form for their
populated semi-urban structure with moderate social signature or thumbprint. An interpreter was engaged to
amenities compared to Mafi-Adidome, which has scattered explain the contents of the consent form to participants
settlements with fewer amenities. According to the 2010 who could not read and write.
Population and Housing Census, the population of the 2.3.1. Inclusion and exclusion criteria
Central Tongu District was 59,411, consisting of 53.2%
females and 46.8% males, with a general fertility rate of 94.9 To be included in the study, a participant first had to
births per 1000 women aged 15–49 years (Ghana Statistical be confirmed as pregnant by a urine human chorionic
Service, 2014a). The population of the North Tongu District gonadotropin test and declared human immunodeficiency
was 89,777, consisting of 52.7% females and 46.3% males, virus negative by standard hospital testing. Only participants
with a general fertility rate of 84.4/1000 women aged residing in the study area who were visiting the hospitals
15–49 years (Ghana Statistical Service, 2014b). for the first time with the current pregnancy and had given
consent to be part of the study were recruited. Participants
Adidome Government Hospital is the main referral who lived more than 10 km from the health center were
center within the Central Tongu District. The hospital, excluded. All pregnant women who reported for delivery
though relatively small with limited modern health- and consented to be part of the study were recruited.
care infrastructure, offers general health-care services.
Its catchment area extends well beyond Mafi-Adidome 2.4. Study design
Township and includes neighboring towns and small This study adopted a cross-sectional survey design
communities such as Mepe, Volo, Mafi-Kumase, Bakpa, targeting pregnant women attending either a public or
and Battor. The hospital encourages all patients to the private health facility for their first ANC visit and delivery.
facility to subscribe to the NHIS because of the general It forms part of a large collaborative research project
inability of people to pay for the full cost of treatment. between the Noguchi Memorial Institute for Medical
Other smaller privately owned clinics and Community Research at the University of Ghana and the Institute of
Health and Planning Services (CHPS) compounds are Research and Development (IRD), a French public research
located within the district, offering certain categories of institution, focusing on malaria-helminth infection during
health care.
pregnancy. The collaborative research study is titled
Battor Catholic Hospital is the main referral center in “Malaria-helminth coinfection in Southern Ghana: issues
the North Tongu District. The hospital offers specialized and challenges in Vaccine Development Against Placental
health-care services and has facilities for training Malaria.” Sociodemographic information and community
resident doctors and house officers. It is a much bigger knowledge on symptoms, transmission, and prevention of
hospital compared to AGH in functionality and is also malaria were collected through questionnaire interviews.
NHIS accredited. The immediate catchment population Clinical information, such as the term of pregnancy and
is about 41,437 inhabitants (Ghana Statistical Service, gestational age, was determined by trained midwives and
2014b). BCH also receives patients from adjoining towns nurses on duty.

Volume 2 Issue 2 (2024) 3 https://doi.org/10.36922/ghes.2336