Social Determinants of Antenatal Care Utilization Among Reproductive Age Women: An Analysis of 2022 Ghana  Demographic and  Health Survey

Background Antenatal care (ANC) is crucial for improving maternal health outcomes, yet full utilization remains an issue in some parts of Ghana. Using the Andersen Behavioral Model, this study examines the social determinants influencing ANC utilization among reproductive-age women in Ghana. Methods Data from the 2022 Ghana Demographic and Health Survey (GDHS) were analyzed, including 5,218 women aged 15–49. The Andersen Model guided the examination of predisposing (age, education, marital status, religion), enabling (wealth quintile, residence), and need factors (childbirth type, health status). Descriptive statistics and logistic regressions were employed to identify significant predictors of ANC utilization. Results Overall, 87.5% of women sought at least four ANC services. Factors significantly associated with increased likelihood of ANC use included higher education (AOR = 4.51, 95% CI: 1.89–10.78) and being in the highest wealth quintile (AOR = 5.98, 95% CI: 3.20–11.17). Additionally, women aged 25 to 34 (AOR = 1.35, 95% CI: 1.09–1.67) were more likely to use ANC compared to other age groups. In contrast, women in very poor health (AOR = 0.50, 95% CI: 0.18–1.36) and those adhering to traditional or other beliefs (AOR = 0.43, 95% CI: 0.32–0.57) were less likely to seek ANC. Marital status, religion, residence, and type of childbirth were not found to be statistically significant factors for ANC services utilization, with the exception of being married. Conclusions Education, marital status, and wealth were crucial determinants of ANC utilization, highlighting the importance of addressing socio-economic and cultural barriers to improve ANC coverage. Given the implementation of Ghana’s free maternal health services policy, future studies should explore the indirect costs and barriers that prevent women from using ANC.