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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
arts and humanities
Travel time to maternity care and its effect on utilization in rural Ghana: A multilevel analysis
Social Science and Medicine, Volume 93, Year 2013
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Description
Rates of neonatal and maternal mortality are high in Ghana. In-facility delivery and other maternal services could reduce this burden, yet utilization rates of key maternal services are relatively low, especially in rural areas. We tested a theoretical implication that travel time negatively affects the use of in-facility delivery and other maternal services. Empirically, we used geospatial techniques to estimate travel times between populations and health facilities. To account for uncertainty in Ghana Demographic and Health Survey cluster locations, we adopted a novel approach of treating the location selection as an imputation problem. We estimated a multilevel random-intercept logistic regression model. For rural households, we found that travel time had a significant effect on the likelihood of in-facility delivery and antenatal care visits, holding constant education, wealth, maternal age, facility capacity, female autonomy, and the season of birth. In contrast, a facility's capacity to provide sophisticated maternity care had no detectable effect on utilization. As the Ghanaian health network expands, our results suggest that increasing the availability of basic obstetric services and improving transport infrastructure may be important interventions. © 2013 Elsevier Ltd.
Authors & Co-Authors
Masters, Samuel H.
United States, Seattle
University of Washington
Burstein, Roy
United States, Seattle
University of Washington
Amofah, George K.
Ghana, Accra
Ghana Health Service
Abaogye, Patrick
Ghana, Accra
Ghana Health Service
Kumar, Santosh
United States, Seattle
University of Washington
Hanlon, Michael
United States, Seattle
University of Washington
Statistics
Citations: 87
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1016/j.socscimed.2013.06.012
ISSN:
02779536
e-ISSN:
18735347
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Ghana
Participants Gender
Female