Observational studyTropical medicine & international health : TM & IH2020
Spatial inequalities in skilled attendance at birth in Ghana: a multilevel analysis integrating health facility databases with household survey data.
Observational study in Tropical medicine & international health : TM & IH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How applicable is geospatial analysis in maternal and neonatal health in sub-Saharan Africa? A systematic review.Journal of global health · 2022Pooled it
- Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar's slums.BMJ open · 2025Article
- An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017-2018.BMC pediatrics · 2024Article
- An explanation of the stagnant under-5 mortality rate in Bangladesh using multilevel, multivariable analysis of three Demographic and Health Surveys.Scientific reports · 2024Article
- Measuring spatial inequalities in maternal and child mortalities in Pakistan: evidence from geographically weighted regression.BMC public health · 2024Article
- Article
- A Methodology for Integrating Population Health Surveys Using Spatial Statistics and Visualizations for Cross-Sectional Analysis.SN computer science · 2023Article
- Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study.BMC public health · 2022Article
- Distance is "a big problem": a geographic analysis of reported and modelled proximity to maternal health services in Ghana.BMC pregnancy and childbirth · 2022Article
- Delineating natural catchment health districts with routinely collected health data from women's travel to give birth in Ghana.BMC health services research · 2022Article
- Differences between gridded population data impact measures of geographic access to healthcare in sub-Saharan Africa.Communications medicine · 2022Article
- Multilevel geospatial analysis of factors associated with unskilled birth attendance in Ghana.PloS one · 2021Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveThis study aimed at using survey data to predict skilled attendance at birth (SBA) across Ghana from healthcare quality and health facility accessibility.
methodsThrough a cross-sectional, observational study, we used a random intercept mixed effects multilevel logistic modelling approach to estimate the odds of having SBA and then applied model estimates to spatial layers to assess the probability of SBA at high-spatial resolution across Ghana. We combined data from the Demographic and Health Survey (DHS), routine birth registers, a service provision assessment of emergency obstetric care services, gridded population estimates and modelled travel time to health facilities.
resultsWithin an hour's travel, 97.1% of women sampled in the DHS could access any health facility, 96.6% could reach a facility providing birthing services, and 86.2% could reach a secondary hospital. After controlling for characteristics of individual women, living in an urban area and close proximity to a health facility with high-quality services were significant positive determinants of SBA uptake. The estimated variance suggests significant effects of cluster and region on SBA as 7.1% of the residual variation in the propensity to use SBA is attributed to unobserved regional characteristics and 16.5% between clusters within regions.
conclusionGiven the expansion of primary care facilities in Ghana, this study suggests that higher quality healthcare services, as opposed to closer proximity of facilities to women, is needed to widen SBA uptake and improve maternal health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.