Type of Health Facility and Utilization of Antenatal Care Services Among Ghanaian Women

This study examined if differences exist in the number and timing of antenatal care (ANC) visits for users of public and private health care facilities in Ghana. Also, the study explored if such variations could be attributed to health-provider factors or the selective socioeconomic characteristics of the users. Data were drawn from the recently collected Ghana Demographic and Health Survey and from a representative sample of t 2135 women who attended antenatal care in a health facility 6 months preceding the survey. Random-effects Poisson and logit models were employed for analysis. Results showed statistically significant differences between users of private and public health facilities for number of ANC visits, but not for the timing of such visits. Although some health-provider factors were significantly associated with ANC visits, these factors did not explain why users of private health facilities had significantly higher number of ANC visits than users of public health facilities. Differences in ANC visits for both private and public health facilities were rather explained by the selective socioeconomic characteristics of the users, especially as wealthy and educated women patronized private health care than poorer and uneducated women. The study concludes that Ghanaian women attending private health facilities may not have improved access to antenatal care compared to those attending public health facilities, and adds to the emerging body of literature that questions private health care in sub-Saharan Africa as more effective than public health care.