Determinants of Compliance With the WHO 2016 Eight-Contact Antenatal Care Model Among Women in Obuasi Municipality, Ghana
Richard Tembila Naab, Elvis Angelo Appiah, Prudence Petio, George Sarpong Agyemang, Jeffrey Kaba, Brian Nsohbono Atinga, Eric Adjei BoaduBackground
Compliance with the WHO 2016 eight-contact antenatal care (ANC) model remains low in many developing countries, limiting improvements in maternal and neonatal health. Evidence on adherence in Ghana is limited, particularly at the sub-national level. This study assessed the level and determinants of compliance with the WHO-recommended ANC schedule among postnatal women in Obuasi Municipality, Ghana.
Methods
A cross-sectional study was conducted among 415 postnatal women attending clinics. Data on predisposing, enabling and need factors based on Andersen’s Health Service Utilisation Model were collected using a structured questionnaire and verified from maternal and child health record books. Respondents were selected via systematic sampling. Compliance was defined as completing eight or more ANC contacts. Multivariate logistic regression identified predictors of compliance (p < 0.05).
Results
Overall, 56.4% of participants completed the eight-contact model. Living >5 km from a facility (aOR=6.55; 95% CI: 1.94–22.09), knowledge of the eight-visit recommendation (aOR=3.58; 95% CI: 1.44–8.91), and NHIS membership (aOR=18.22; 95% CI: 1.98–167.49) increased compliance, while booking after 12 weeks reduced compliance (aOR=0.42; 95% CI: 0.19–0.90). Long waiting times (>60 minutes) (aOR=0.39; 95% CI: 0.18–0.86) and single transit transport routes (aOR=0.39; 95% CI: 0.15–0.99) also reduced compliance.
Conclusion
Compliance with the WHO eight-contact ANC model was moderate. Early ANC initiation, NHIS enrollment, and knowledge of the recommended schedule improved adherence. Interventions should focus on early education, reducing waiting times, and improving access to enhance compliance and maternal outcomes.