Impact of eight or more antenatal care visits on intermittent preventive treatment of malaria uptake during pregnancy and facility-based delivery in Ghana: a propensity score matched analysis
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Date
2026-02-24
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Nature
Abstract
Introduction
Maternal and malaria-related morbidity remain major public health challenges in sub-Saharan Africa, particularly in Ghana. The World Health Organization (WHO) recommends eight or more antenatal care (ANC8+) contacts to enhance maternal and child health, but its effect on malaria prevention and delivery outcomes is not well established. This study examined the impact of ANC8 + visits on facility-based delivery and optimal uptake of intermittent preventive treatment for malaria during pregnancy (IPTp-SP).
Methods
Data were drawn from the 2022 Ghana Demographic and Health Survey, including women aged 15–49 years who had given birth within the three years preceding the survey. Propensity score matching was applied to estimate the effect of ANC8 + visits on facility-based delivery and uptake of at least three IPTp-SP doses.
Results
Only 38.7% of women met the ANC8 + threshold. Among all respondents, 85.4% delivered in a health facility, and 66.5% received three or more IPTp-SP doses. After matching, ANC8 + attendance increased the likelihood of facility delivery by 8.2% points (ATT = 8.2, 95% CI: 4.6–11.9) and optimal IPTp-SP uptake by 11.1% points (ATT = 11.1, 95% CI: 6.8–15.4).
Conclusion
Adherence to WHO’s ANC8 + recommendation significantly improves facility-based delivery and malaria prevention during pregnancy. Strengthening policies that enhance ANC attendance, particularly among socioeconomically and geographically disadvantaged groups, is essential for advancing maternal and child health in Ghana.
Description
Adhering to the WHO recommendation of 8 or more antenatal care visits greatly increases facility-based delivery and the uptake of malaria preventive treatment, strengthening maternal and child health. These results directly support policies that expand access to quality antenatal care, with a focus on vulnerable groups facing socio-economic or geographic challenges. The research advances SDG 3 by reducing malaria-related maternal morbidity and SDG 10 by promoting equitable health services. This evidence aligns with Uganda's National Development Plan IV priorities for maternal healthcare, disease prevention, and health system effectiveness.
Keywords
Maternal health, Antenatal care, Sub-Saharan Africa, Maternal mortality
Citation
Agbi, D. M., Mwebesa, E., Jimmy, A. I., Valère, S. K., & Kerich, G. K. (2026). Impact of eight or more antenatal care visits on intermittent preventive treatment of malaria uptake during pregnancy and facility-based delivery in Ghana: a propensity score matched analysis. BMC Pregnancy and Childbirth.