We investigate the determinants of antenatal care use in Ghana using a largescale
living standard survey. Most previous studies on the subject have used surveys that
focus on demography and fertility, and have used approximate indicators of economic
variables such as income and cost of consultation. This leads to an overestimation of effects
when explanatory factors pick up the effect of underlying economic conditions.
We describe antenatal care demand as a three level nested multinomial logit model that
includes more appropriate economic explanatory variables. The estimation results show that
indeed income, cost of consultation and in particular travel distance to the health care facility
are significantly associated with the demand for antenatal care.
Use of sufficient antenatal care can thus be promoted effectively by extending the supply of
antenatal care services in the rural area. In addition, education of the mother is positively
associated to choice for sufficient antenatal care, while women having more pregnancy
experience tend to underutilize antenatal care. This suggests that campaigns to promote
sufficient antenatal care should pay special attention to education and to women who already
gave birth. The results further indicate that, in contrast to findings elsewhere, a special
targeting of antenatal care according to religion seems unwarranted.