Page 115 - GHES-2-2

Global Health Econ Sustain Antenatal care attendance

Table 5. Level of knowledge on malaria causes, symptoms, risks, general prevention, and prevention during pregnancy
ANC health facility (n [%]) Test statistic (p‑value) Delivery health facility (n [%]) Test statistic (p‑value)
Adidome Battor Adidome Battor
2
2
Knowledge level χ (2)=124.37 (p < 0.001) χ (2)=26.22 (p < 0.001)
Low 246 (55.2) 81 (21.3) 145 (48.2) 46 (28.2)
Medium 202 (44.8) 263 (69.2) 137 (45.5) 87 (53.4)
High 0 (0.0) 36 (9.5) 19 (6.3) 30 (18.4)
Total 451 (100.0) 380 (100.0) 301 (100.0) 163 (100.0)
Mean (SD) 33.2 (9.8) 46.6 (16.6) 34.8 (20.0) 48.5 (21.1)
Note: Knowledge level: Low: 0 – 33.33%; Medium: 33.34 – 66.66%; High: 66.67 – 100%.
Abbreviations: ANC: Antenatal care; SD: Standard deviation.

middle belt of Ghana and Abubakari et al. (2018) in trimesters, potentially impacting maternal morbidity and
northern Ghana, where marital status was associated mortality rates. Approximately 50% of the pregnant women
with ANC attendance. Similarly, a study in Rwanda found attended the recommended 4 – 7 ANC visits, mirroring
that unmarried, widowed, or divorced pregnant women observations from other regions in Ghana (Boah et al.,
were less likely to make the recommended number of 2018; Sakeah et al., 2017; Sumankuuro et al., 2017).
ANC visits (Rurangirwa et al., 2017). It is plausible that Intermittent preventive treatment of malaria in
pregnant women living in urban communities with pregnancy with sulfadoxine-pyrimethamine has been
supportive spouses may have higher financial resources, endorsed by the WHO to prevent malaria in pregnancy,
potentially explaining the higher numbers of married with the recommendation of at least three doses at
ANC participants observed in BCH, where services may
come at a higher cost compared to AGH. scheduled ANC visits. Results from our study indicate a
median of three doses of IPTp-SP at each health facility
The high proportion of participants with primary (Table 4), aligning with the WHO recommendations
and junior school education (Table 1) suggests a high established in September 2012 for protection against
rate of school dropout in the study areas. However, malaria in pregnancy.
Battor-Dugame, being a semi-urban area, likely has
more educational facilities compared to Mafi-Adidome, The GHS has implemented pregnancy schools as
explaining the higher proportion of senior high school and an innovative approach to educating pregnant women
tertiary graduates observed at BCH. This observation is on maternal and child health. In the study areas, these
consistent with the findings of Muyunda et al. (2016), who pregnancy schools are conducted during ANC visits
found that, in Zambia, women with higher education were and have shown some success, particularly in educating
more likely to make at least four ANC visits, indicating participants in AGH about the timing of IPTp-SP. At ANC
an association between education and optimal ANC enrollment, only 21.1% of participants were aware that
attendance. The high incidence of school dropout in the IPTp must be administered in the first trimester. However,
study areas, however, may account for the generally low this awareness increased to 52.5% at delivery, indicating
ANC attendance. Nonetheless, the higher numbers of basic the effectiveness of continuous education provided at these
school (primary and junior high school) leavers observed pregnancy schools. The high percentage of participants
in AGH may reflect a lower cost of ANC and delivery care receiving IPTp-SP, 91.0% at AGH and 97.6% at BCH,
offered at that facility. underscores the successful coverage of IPTp administration
at the two study sites.
Collectively, participants at BCH demonstrate a
better understanding of the importance of ANC and the Ownership and consistent use of mosquito bed nets
timing of IPTp administration (Table 3). Despite this are essential components of the WHO interventions
observation, only 45.0% of BCH participants, compared to aimed at reducing malaria transmission and morbidity in
51.5% at AGH, initiated ANC visits in the first trimester, communities. In addition to IPTp-SP, the high proportion
in accordance with the WHO recommendations. This of participants who possessed and regularly used
observation aligns with other studies in rural communities mosquito bed nets suggests the effectiveness of the Roll
in both southern and northern Ghana (Manyeh et al., Back Malaria program in the study areas. This success is
2020; Sumankuuro et al., 2017), where only 50% of the reflected in the low prevalence of malaria and pregnancy-
participants initiated ANC visits in the first and second related complications observed among the participants at

Volume 2 Issue 2 (2024) 9 https://doi.org/10.36922/ghes.2336