Factors Influencing Home Deliveries among Reproductive Women and Their Impact on Maternal and Child Health in Tano North Municipality, Ghana

Abstract

Background: Home deliveries remain a major contributor to maternal and neonatal morbidity and mortality in Ghana, particularly in rural areas. Understanding the socio-cultural, economic, and systemic barriers to skilled birth attendance is critical for effective maternal health interventions. Objective: This study investigated the factors accounting for home deliveries and their associated impacts among women in Tano North Municipality. Methods: A descriptive cross-sectional design was employed. Using a structured questionnaire, data were collected from a purposively selected 300 women of reproductive age who had recently given birth at home within the past year. Convenience sampling was used and the data were analyzed using SPSS version 25, and descriptive statistics were presented in frequency tables. Results: The majority of respondents disagreed that poor health service quality or negative staff attitudes influenced home deliveries. However, long distances to health facilities (66.7%) and high delivery costs (21.6%) were cited as major reasons for choosing home delivery. Key barriers to skilled birth attendance included cultural practices (53.3%), poor road conditions, and instances of neglect and verbal abuse by healthcare workers. Health outcomes linked to home delivery included increased risks of infection (94.3%), obstetric complications (94.3%), maternal death (80.7%), and neonatal death (77.9%). Conclusion: Structural, cultural, and interpersonal barriers significantly influence delivery location in Tano North Municipality. Community-based interventions, infrastructure development, and respectful maternity care initiatives are essential.