Abstract
Background To understand differences in access to reproductive healthcare services, the use of family planning and maternal care by women in Ghana and Nigeria is examined.Methods We used population-level data from the Ghana and Nigeria Demographic Health Surveys of 2014 and 2013 in two-step cluster analysis followed by multinomial logistic regression analysis.Results The initial two-step cluster analyses on family planning identify three groups of women in Ghana and Nigeria: women with high, medium and poor access to family planning services. The subsequent two-step cluster analyses identify five distinct groups: higher, high, medium, low and poor access to maternal health services in Ghana and Nigeria. The multinomial logistic regression shows that education and occupation are associated with access to family planning and maternal health services. Women without education often have poor access to reproductive health services in both countries. In Nigeria, household wealth is strongly associated with access to maternal health services but household wealth does not explain access in Ghana. Not having insurance in Ghana is associated with low access to family planning service, while this is not the case in Nigeria.Conclusions These differences confirm the importance of a focused context-specific approach towards reproductive health services, particularly to reduce inequality in access resulting from socioeconomic status.
Knowledge, attitudes and peer influences related to pregnancy, sexual and reproductive health among adolescents using maternal health services in Ugu, KwaZulu-Natal, South Africa
