Report of doctor or midwife vs. CHO was associated with statistically significant increased report of ANC services and nearly 3:1 odds of reporting the comprehensive maternal care package (P?<?0.01). Consistent with prior studies <a href="http://www.selleckchem.com/products/Thiazovivin.html
">Thiazovivin in vivo documenting the influence of maternal demographics on antenatal provider type in Ghana, in this sample of rural women we found the covariates of maternal wealth and education to be positively associated with longer training and increased maternal specialization of antenatal provider (GSS et al. 2009b; Arthur 2012). Wealth and education are well-established global predictors of access to health services. In Ghana's most rural regions, the critical workforce shortage is manifest in a doctor to population ratio ranging from 1:30?000 to 1:90?000 persons (GHS 2008). This shortage is a likely driver of women from higher socio-demographic profiles having relatively better access to doctors than women from lower socio-demographic strata. There was no difference within the dichotomous covariates of maternal wealth and education TGF-beta cancer
and maternal report of midwives as antenatal provider, suggesting that midwives are a relatively equitable workforce category across socio-demographic status. The negative association between increased wealth and education and maternal report of CHO antenatal providers supports other studies that have found this decade-old mid-level workforce to be successful in reaching the clientele for which their provider type was designed: poor, rural women (Awoonor-Williams et?al. 2004; Binka et?al. 2007). Finally, we saw a positive association between health insurance Sotrastaurin
and report of skilled antenatal provider, which is consistent with Mensah et?al.'s (2010) findings that Ghana's relatively nascent health insurance scheme appears to be an independent predictor of maternal services. Maternal care in rural Ghana does vary by antenatal provider type. There is a positive association between antenatal provider length of training and maternal specialization and report of maternal services, taking covariate differences into account. Although less than one-fifth of women in this sample report doctors as antenatal provider, those that do, report more antenatal, skilled delivery and post-partum services than other antenatal providers. Accordingly, women who report midwives as antenatal provider report increased maternal services compared with CHOs. Our findings are consistent with our hypothesis and supported by studies in which quality of health services appears to be higher from doctors compared with other provider categories (Rowe et?al. 2007; Brentlinger et?al. 2010). The positive relationship between report of doctors and midwives and maternal services is no doubt driven by their professional mandate to provide the full breadth of services included in this analysis, including skilled delivery and post-partum check.