Background
Globally, maternal mortality remains high at 216 per 100,000 live births
. Current projections suggest the United Nations Sustainable Development
Goals (SDGs) target to reduce maternal mortality to 70 per 100,000 live
births by 2030 is unlikely to be achieved unless there is substantial
additional investment in maternal and child survival, particularly in
sub-Saharan Africa . If each country continues to reduce its maternal
mortality ratio (MMR) at the current trend, an estimated 3.9 million
women would die of maternal-related causes within the next 15 years . An
acceleration of the pace of decline in maternal and child mortality,
stillbirths and stunting of children will require a rapid scale-up of
effective interventions . Thus, critical analyses of strategies are
needed to inform countries striving to achieve the SDG mortality
reduction targets
Pregnancy complications and adverse birth outcomes are among the key
challenges confronting maternal and child health and pose significant
public health concerns . Adverse pregnancy outcomes are known to be
associated with infant and maternal mortality and physical and
psychological disorders, contributing to ongoing healthcare costs.
Therefore, improvement in pregnancy outcomes is key to the attainment of
the sustainable development goals on maternal and child health.
Adverse pregnancy outcomes include a wide range of health challenges
that happen to either the newborn or mother during pregnancy, delivery,
or postpartum . They are among the most important indicators used to
assess maternal and child health since they provide critical insights on
the availability and use of quality maternal and child health services
including antenatal and postnatal care, skilled delivery etc.
Globally, It is estimated that 810 mothers die each day from preventable
pregnancy-related complications and over 90% of these deaths occur in
developing countries such as Ghana . Sixty-six per cent (196,000) of all
preventable maternal deaths occur in Sub-Saharan Africa . In Ghana,
maternal mortality reduced from 484 per 100,000 live births in the year
2000 to 308 per 100,000 live births in 2017 falling short of the MDGs .
Inequalities in access to and use of maternal and child health services
expose millions of disadvantaged women and children to the risk of
preventable diseases, ill health and deaths . The underlying causes of
disparities in health between less and more advantaged groups of people
are multifactorial and complex . Health and access to healthcare is a
social commodity since it is influenced by social policies including the
policies and programs affecting the allocation and financing of
healthcare and the quality of services delivered . Income, occupational
status, economic assets, educational level, ethnicity/ race or religious
affiliation, age, geography, sexual orientation and disability are among
the major social determinants of health .This study aims to examine the
effect of one of Ghana’s flagship primary healthcare programs on
pregnancy outcomes and equity improvement.