INFLUENCE OF HEALTH WORKER ATTITUDES AND QUALITY OF MATERNAL HEALTHCARE SERVICES ON ANTENATAL CARE ADHERENCE AMONG MULTIPAROUS WOMEN IN RURAL GHANA: A MIXED-METHODS STUDY IN KPASSA, OTI REGION

Maternal mortality remains a major public health concern in developing countries, including Ghana. Antenatal care (ANC) is recognized as an important strategy for improving maternal and neonatal outcomes. Despite the availability of free maternal health services in Ghana, utilisation and adherence to ANC services among multiparous women in rural communities remain inadequate. This study assessed the effect of health worker attitude and quality of maternal health services on antenatal care adherence among multiparous women in rural health facilities, with specific emphasis on the Kpassa community in the Nkwanta North District of the Oti Region. The study adopted a mixed-method research approach. Primary data were collected from 100 multiparous women in their third trimester through purposive sampling techniques. Findings revealed that 76% of them had received ANC service and was influenced by health worker attitude, emotional support, empathy, quality of care, socio-economic conditions, cultural beliefs, and family support systems. Majority of 40 respondents attended their first ANC when they were within the second trimester (13 to 28 weeks) which represent 52% of the total respondents while 15 of the respondents attended their first ANC when they were within the third trimester (29 to 36 weeks) which represent 21%. The study found that poor attitudes of health workers, including lack of empathy, rude behavior, long waiting time, and inadequate emotional support discouraged ANC attendance. The study concluded that improving the quality of maternal healthcare services and promoting positive health worker attitudes are essential in enhancing ANC adherence among multiparous women in rural communities. The study recommends intensified public education on antenatal care, inclusion of men in maternal health education, strengthening interpersonal skills among healthcare workers. The introduction of mobile ANC services to improve accessibility and adherence among multiparous women in rural settings can be achieved.