Factors predicting home delivery among women in Bosomtwe-Atwima-Kwanwoma district of Ghana: A case control study

Background: Maternal mortality is unacceptably high in Ghana. This situation is attributed partly to non-availability of healthcare services and poor utilization of these services when they are available. More deliveries are still performed at home, and in many cases, without the supervision of trained attendants, despite the Ghana Government’s fee exemption policy on maternal deliveries. The purpose of this study was to identify factors that predict home delivery among mothers. Materials and Methods: An unmatched case control study was conducted among mothers in the Bosomtwe-Atwima-Kwanwoma district of Ghana. A total of 114 mothers consisting of 54 cases and 60 controls participated in the study. A multi-stage sampling technique was used to select participants of the study. Data were collected using pre-tested questionnaires and analyzed using EPIINFO (3.3) and STATA (8.2) statistical software. Results: Mothers aged 31 years and above (AOR 3.00, 95% CI: 1.16-7.74) and those with primary or no formal education (AOR 3.88, 95% CI: 1.60-9.46) were more likely to deliver at home. Also, the risk of home delivery for mothers with more antenatal care (ANC) clinic visits was less by 0.3 (30%) (AOR 0.70, 95% CI: 0.53-0.88). Conclusion: The factors influencing home delivery among mothers were maternal ages of 31 years and above, primary or no formal education, and less than four ANC visits. Interventions aimed at improving female education, increasing the number of ANC visits, and providing counselling, follow-up, and support to older pregnant mothers are recommended to increase the number of women who deliver in healthcare facilities.