Availability of Water and Utilization of Skilled Delivery in Maternity Wards: A Quasi-Experimental Study in Talensi and East Mamprusi Districts

Authors

  • Mohammed Ali College of Community and Organizational Development, Ghana
  • Rashid Bawumia Ali University for Development Studies, Ghana
  • Barnabas Kwame Yeboah NAfrica Centres for Disease Prevention and Control, Ghana

DOI:

https://doi.org/10.54536/ajmsi.v5i2.6459

Keywords:

Access to Water, Facility Readiness, Maternal Mortality, Northern (Talensi East Mamprusi) Ghana, Skilled Delivery Use

Abstract

Maternal mortality continues to be a major public health concern in northern Ghana which is partly ascribed to socio-cultural limitations coupled with poor accessibility to safe maternal delivery services. The availability of safe water in hospital maternity units is crucial for infection prevention, facility readiness, and patient satisfaction. But many health facilities in rural areas don’t have reliable access to water. Clean and safe water, adequate toilets, good hygiene practice, and enough water to wash and for waste disposal at care point hand hygiene facilities and at the toilet are essential services under WHO WASH in HCF standards. This quasi-experimental, mixed approaches research aim at assessing the effects of water supply on utilization of skilled delivery services in Talensi and East Mamprusi District. Recruitment of 840 women aged 15–49 who visited selected facilities for delivery between December 2020 and January 2025 was undertaken, with information from midwives and facility managers added. The facilities were grouped into intervention (mechanized boreholes) and control (no sustained source of water). Quantitative data were conducted using SPSS and STATA, including chi-square testing, logistic regression analysis, multi-level model analysis and propensity score matching. Qualitative interview data were analyzed using thematic analysis. Results: Intervention centers were better prepared in readiness components such as hygiene, sterility and cleanliness. At intervention sites, skilled attendance was more common 15 percentage points and water access doubled the odds of SBA (OR = 1.92, CI: 1.35–2.73). These quantitative findings were echoed by qualitative data with mothers’ focus on safety and dignity in water delivering wards, while staff spoke of improvements in timeliness and infection control. Consistent access to clean water supports adoption of maternal health services. The link between water and health is particularly pertinent for maternal health: as such, WASH in maternity wards should be a priority area for policymakers, and progress towards improvements in maternal health should be monitored through the lens of water-access indicators. Additional research is needed in other districts and should include cost-benefit analyses of neonatal outcomes. Clean water at birth is the cornerstone of dignity and life-saving results.

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References

Abukari, K., Alhassan, S., Apatinga, G. A., & Owusu, F. K. (2023). Water (In)Accessibility, healthcare delivery, and patients’ health outcomes in Ghana: Perspectives from the Yendi Hospital. Nursing Reports, 15(12), 418. https://doi.org/10.3390/nursrep15120418

Afrifa, A. D., Prah, J. K., & Nkrumah, K. S. (2021). Utilisation of skilled delivery in Ghana: A systematic review. Extensive Reviews, 1(1), 30–38. https://doi.org/10.21467/exr.1.1.4426

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10. https://doi.org/10.2307/2137284

Austin, P. C. (2011). An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research, 46(3), 399–424. https://doi.org/10.1080/00273171.2011.568786

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Cook, T. D., Campbell, D. T., & Shadish, W. R. (2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin.

Countdown 2030. (2024). Chartbook Ghana 2024: Analysis of reproductive, maternal, newborn, child and adolescent health indicators 2019–2023. https://www.countdown2030.org

Ganle, J. K., Fitzpatrick, R., Otupiri, E., & Parker, M. (2016). Addressing health system barriers to access to and use of skilled delivery services: Perspectives from Ghana. International Journal of Health Planning and Management, 31(3), e235–e253. https://doi.org/10.1002/hpm.2291

Ghana Health Service. (2022). Annual Report 2021. Accra: GHS.

Ghana Health Service. (2023). Annual health sector performance report 2022–2023. https://www.ghs.gov.gh

Ghana Statistical Service. (2021). 2021 Population and Housing Census: General Report. Accra: GSS.

Global Communities. (2022). The role of WASH in sustaining maternal health during delivery: Reflections from Ghana’s WASH for Health program. Retrieved from https://globalcommunities.org

Hosmer, D. W., Lemeshow, S., & Sturdivant, R. X. (2013). Applied logistic regression (3rd ed.). Wiley.

Issah Baddianaah, Dongzagla, A., & Salifu, S. N. (2024). Navigating access to safe water by rural households in sub-Saharan Africa: Insights from north-western Ghana. Sustainable Environment, 10(1), 2303803. https://doi.org/10.1080/27658511.2024.2303803

Kadam, P., & Bhalerao, S. (2010). Sample size calculation. International Journal of Ayurveda Research, 1(1), 55–57. https://doi.org/10.4103/0974-7788.59946

Kosoe, E. A., Asabere, S. B., & Amuakwa-Mensah, F. (2025). Reimagining rural and small-town water supply in Ghana through inclusive governance and sustainable models. Journal of Sustainability. https://journalofsustainability.net/wp-content/uploads/2025/07/Kosoe_et_al_Reimagining_Rural_and_Small-Town_Water_Supply_in_Ghana_through_Inclusive_Governance_and_Sustainable_Models.pdf

Kosoe, E. A., Asabere, S. B., & Amuakwa-Mensah, F. (2025). Reimagining rural and small-town water supply in Ghana through inclusive governance and sustainable models. Journal of Sustainability. https://journalofsustainability.net/wp-content/uploads/2025/07/

Kumah, E., Kokuro, C., Ankomah, S. E., Fusheini, A., Agyei, E., & Anaba, C. L. (2025). Low utilization of skilled delivery services in rural sub-Saharan Africa: A case for facility delivery improvement. Journal of Public Health Policy, 46, 211–221. https://doi.org/10.1057/s41271-024-00542-w

Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403

Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin.

UNICEF. (2024). Health budget brief 2024: Republic of Ghana. UNICEF Ghana. https://www.unicef.org/ghana

Velleman, Y., Mason, E., Graham, W., Benova, L., Chopra, M., Campbell, O. M. R., Gordon, B., Wijesekera, S., Hounton, S., Esteves Mills, J., Curtis, V., Afsana, K., Boisson, S., Magoma, M., Cairncross, S., & Cumming, O. (2014). From joint thinking to joint action: A call to action on improving water, sanitation, and hygiene for maternal and newborn health. PLOS Medicine, 11(12), e1001771. https://doi.org/10.1371/journal.pmed.1001771

World Health Organization. (2015). Service Availability and Readiness Assessment (SARA): An annual monitoring system for service delivery. Geneva: WHO.

World Health Organization. (2022). Improving sustainable health financing and primary health care to achieve universal health coverage in Ghana. WHO Newsroom. https://www.who.int/news-room/feature-stories/detail/health-financing-primary-health-care-ghana-universal-health-coverage-roadmap

World Health Organization. (2023). Skilled birth attendance global estimates. Geneva: WHO.

World Health Organization. (2023). Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. WHO. https://www.who.int/publications

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Published

2026-07-22

How to Cite

Ali, M., Ali, R. B., & Yeboah, B. K. (2026). Availability of Water and Utilization of Skilled Delivery in Maternity Wards: A Quasi-Experimental Study in Talensi and East Mamprusi Districts. American Journal of Medical Science and Innovation, 5(2), 33-41. https://doi.org/10.54536/ajmsi.v5i2.6459

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