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.