Effect of healthcare quality initiative on maternal healthcare service utilization: a case study of the SPRING Ghana project

BACKGROUND: Between 2014 and 2017, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), Ghana implemented a nutrition project in two regions of the country using a quality improvement approach. The quality improvement approach focused on improving antenatal care attendance and institutional births. OBJECTIVES: This study examines the effect of the quality improvement initiative on maternal healthcare service utilization in Ghana and whether the services provided were of quality. METHOD: We use the 2014 and the 2008 Ghana Demographic and Health Survey dataset, which is a cross sectional survey and the difference-in-difference approach. RESULTS: We find strong positive association of the project impact on the probability of antenatal care attendance during the first trimester by 12% points while institutional births were seen to be 8% points. We also find a statistically significant impact of the care rendered by the nurse/midwife to be 13% points and the community health officer/nurse by 4.5% points. CONCLUSION: The findings indicate that pregnant women in the intervention regions were more likely to deliver at the health facilities than in the non-intervention regions. It is therefore recommended that Ghana and other low resource countries can better improve maternal health care service uptake with the incorporation of quality improvement tools in maternal health care policy designs.