High Antenatal Attendance, Low Facility Delivery: Assessment of Factors Influencing Facility Delivery in a University Hospital in Ghana

In Ghana, though there has been a decline in maternal mortality from 760 deaths per 100,000 live births in 1990 to 319 deaths per 100,000 live births in 2015, it is still very high. Complications that may arise from pregnancy are impossible to predict. Thus, World Health Organization (WHO) duly recommends delivery by a skilled birth attendant (SBA). This study is to access the factors contributing to the high ANC coverage, but low facility delivery in the Tamale Technical University Hospital. The study used analytical cross-sectional design to include 293 pregnant women attending ANC at Ta TU Hospital. Using simple random SPSS version 26 and STATA version 17 was used for data entry and analysis. The demographic characteristics of the respondents was analyzed and presented using descriptive statistics in the form of frequency and percentages. Logistic regression used to determine the factors contributing high ANC coverage but low skilled delivery. Age, education, previous pregnancy experience, presence of medical professionals, the desire to avoid complications, and the desire to reduce waiting time and medication costs were all found to be significant(p<0.001) Age, education, and previous pregnancy experience play significant roles in the preference for delivering at the hospital. Factors such as the presence of medical professionals, the desire to avoid complications, and the desire to reduce waiting time and medication costs are associated with a higher likelihood of choosing Ta TU Hospital for delivery. However, the study also identifies challenges in accessing the hospital during labor and highlights concerns related to staff confidence, cost, and facility resources as reasons for choosing alternative delivery locations. These findings indicate a need for improved healthcare infrastructure, staff training, and cost-related support to encourage facility-based deliveries.