Determinants of Pregnancy Outcomes in Ghana: Does Quality of Antenatal Care Matter?

Patience A. Afulani, University of California, Los Angeles

Over two million stillbirths occur each year globally. Like maternal deaths, over 98% of stillbirths occur in developing countries. The emphases on skilled birth attendants to prevent maternal deaths may have undermined efforts to provide good quality antenatal care (ANC). This study examines the factors associated with stillbirths in Ghana, focusing on the role of ANC quality. Data are from the Ghana Maternal Health Survey (N=4,868). Multilevel logistic regressions with moderation analysis are employed. Higher quality ANC decreases the odds of having a stillbirth by almost half after accounting for other confounding covariates including type of delivery provider and facility. Completing the recommended four antenatal visits also decreases the odds of having a stillbirth. Having a pregnancy complication, a multiple gestation, or a past stillbirth, increases the odds of having a stillbirth. Targeted efforts to increase ANC quality will help improve maternal and fetal outcomes in Ghana.