African Journal of Public Health and Health Systems | 19 October 2008
Evaluating a Community Health Worker-Led Group Antenatal Care Intervention and Its Effect on Skilled Birth Attendance in Ghana’s Brong-Ahafo Region
K, w, a, m, e, A, s, a, n, t, e, ,, A, m, a, S, e, r, w, a, a, A, d, j, e, i
Abstract
Skilled birth attendance remains a critical public health target in Ghana. Traditional, individual antenatal care models in rural areas face challenges including low attendance and limited health education. Community health worker-led group antenatal care is a proposed alternative, but its effectiveness in improving skilled birth attendance in regions like Brong-Ahafo requires evaluation. This working paper evaluates the effectiveness of a community health worker-led group antenatal care intervention on skilled birth attendance rates in selected districts of Ghana’s Brong-Ahafo Region. The primary objective was to compare skilled birth attendance rates between an intervention and a control group. A quasi-experimental design was employed. Communities were purposively selected and assigned to either the intervention (group antenatal care) or control (standard individual care). Quantitative data on birth outcomes were collected from health facility records. Qualitative data were gathered via focus group discussions with participating women to understand their experiences. Preliminary analysis indicates a positive association between the intervention and skilled birth attendance. A greater proportion of women in the intervention group utilised skilled attendants at birth compared to the control group. Qualitative themes highlighted increased knowledge, social support, and trust in community health workers as potential facilitators of this outcome. The community health worker-led group antenatal care model shows potential for improving skilled birth attendance in the Brong-Ahafo Region. It appears to address some barriers to care access and utilisation present in the standard model. Further analysis with robust statistical testing is required. Programme planners should consider piloting and scaling this model in similar rural settings, ensuring adequate training and resources for community health workers. Policy should support the integration of such community-based models into maternal health strategies. Community health workers, group antenatal care, skilled birth attendance, maternal health, Ghana, quasi-experimental study. This working paper provides preliminary evidence on the implementation and outcomes of a community-based group antenatal care model in a Ghanaian region, contributing to the discourse on alternative service delivery for improving maternal healthcare utilisation.