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Peer-reviewedCC BY 4.0PLOS One

A cross-sectional study to evaluate access to antenatal care services in Twifo Hemang Lower Denkyira district of Ghana

  • John Hammond1
  • Silas Adjei-Gyamfi2
  • Doreen Brew Daniels3
  • Godfred Kwabena Sarpong4
  • Hirotsugu Aiga5
  • Tsunoneri Aoki6
6 affiliations
  1. 1Central Regional Health Directorate, Ghana Health Service, Cape Coast, Central Region, Ghana
  2. 2School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
  3. 3Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
  4. 4Savelugu Municipal Hospital, Ghana Health Service, Savelugu, Northern Region, Ghana
  5. 5Elmina Polyclinic, Ghana Health Service, Elmina, Central Region, Ghana
  6. 6Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
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Abstract

Background: Antenatal care (ANC) supports skilled delivery and maternal survival, but evidence on how Ghana’s Community-Based Health Planning and Services (CHPS) policy influences ANC access is limited. This study assessed factors associated with ANC access in the Twifo Hemang Lower Denkyira District, Central Region, Ghana. Methods: In a cross-sectional study, we examined 310 women aged 15–49 years, having children less than 12 months, using a structured questionnaire administered through interviews. ANC initiation was defined as early when the first ANC visit occurred at 0–12 weeks’ gestation (first trimester) and late when it occurred at 13 weeks or later. We performed univariate and multivariate logistic regression analyses in Stata 17 and reported adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results: ANC attendance was 93.9%, and 69.1% of women initiated ANC early. Unmarried women (AOR = 0.125, 95%CI:0.012–0.926, p = 0.047) and women who delivered at home (AOR = 0.013, 95%CI:0.001–0.176, p = 0.001) had lower odds of attending at least one ANC visit. Late ANC initiation was associated with household size of 11 or more members (AOR = 3.848, 95%CI:1.914–6.211, p = 0.046), fewer than four ANC contacts (AOR = 6.332, 95% CI: 2.049–9.571, p = 0.001), and CHPS staff home visits (AOR = 1.813, 95%CI:1.014–3.243, p = 0.045). Higher monthly income was associated with lower odds of late ANC initiation (AOR = 0.123, 95%CI:0.024–0.630, p = 0.012). ANC and pregnancy knowledge, receiving care in a CHPS zone, and distance to a CHPS zone were not significantly associated with ANC attendance or timing after adjustment. Conclusions: ANC attendance and early initiation were relatively high. However, marital status, place of delivery, household size, income, ANC contacts, and CHPS home visits were associated with ANC access. Strengthening community-based and multisectoral interventions may improve timely ANC use and maternal health outcomes.

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Cite

BibTeXRIS
BibTeX
@article{hammond2026crosssectional,
  title = {{A cross-sectional study to evaluate access to antenatal care services in Twifo Hemang Lower Denkyira district of Ghana}},
  author = {John Hammond and Silas Adjei-Gyamfi and Doreen Brew Daniels and Godfred Kwabena Sarpong and Hirotsugu Aiga and Tsunoneri Aoki},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0359892},
  url = {https://doi.org/10.1371/journal.pone.0359892},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A cross-sectional study to evaluate access to antenatal care services in Twifo Hemang Lower Denkyira district of Ghana
AU  - John Hammond
AU  - Silas Adjei-Gyamfi
AU  - Doreen Brew Daniels
AU  - Godfred Kwabena Sarpong
AU  - Hirotsugu Aiga
AU  - Tsunoneri Aoki
PY  - 2026
DA  - 2026/10/07
JO  - PLOS One
DO  - 10.1371/journal.pone.0359892
UR  - https://doi.org/10.1371/journal.pone.0359892
AB  - Background: Antenatal care (ANC) supports skilled delivery and maternal survival, but evidence on how Ghana’s Community-Based Health Planning and Services (CHPS) policy influences ANC access is limited. This study assessed factors associated with ANC access in the Twifo Hemang Lower Denkyira District, Central Region, Ghana. Methods: In a cross-sectional study, we examined 310 women aged 15–49 years, having children less than 12 months, using a structured questionnaire administered through interviews. ANC initiation was defined as early when the first ANC visit occurred at 0–12 weeks’ gestation (first trimester) and late when it occurred at 13 weeks or later. We performed univariate and multivariate logistic regression analyses in Stata 17 and reported adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results: ANC attendance was 93.9%, and 69.1% of women initiated ANC early. Unmarried women (AOR = 0.125, 95%CI:0.012–0.926, p = 0.047) and women who delivered at home (AOR = 0.013, 95%CI:0.001–0.176, p = 0.001) had lower odds of attending at least one ANC visit. Late ANC initiation was associated with household size of 11 or more members (AOR = 3.848, 95%CI:1.914–6.211, p = 0.046), fewer than four ANC contacts (AOR = 6.332, 95% CI: 2.049–9.571, p = 0.001), and CHPS staff home visits (AOR = 1.813, 95%CI:1.014–3.243, p = 0.045). Higher monthly income was associated with lower odds of late ANC initiation (AOR = 0.123, 95%CI:0.024–0.630, p = 0.012). ANC and pregnancy knowledge, receiving care in a CHPS zone, and distance to a CHPS zone were not significantly associated with ANC attendance or timing after adjustment. Conclusions: ANC attendance and early initiation were relatively high. However, marital status, place of delivery, household size, income, ANC contacts, and CHPS home visits were associated with ANC access. Strengthening community-based and multisectoral interventions may improve timely ANC use and maternal health outcomes.
SN  - 1932-6203
ER  -