Predictors Of Perinatal Mortality In Ghana: A Multilevel Analysis Of 2022 Ghana Demographic And Health Survey

Introduction : Ghana’s high perinatal mortality rates threaten its ability to achieve Sustainable Development Goal 3 by 2030. Understanding the major drivers of perinatal mortality is key to addressing the challenges. We examine the risk factors of perinatal mortality in Ghana using data from the latest Demographic and Health Survey and guided by Andersen’s health utilization model. Method: The study used the 2022 Ghana Demographic Health Survey (GDHS). A total of 9410 mothers age 15 – 49 years who experienced perinatal mortality were included. Pearson’s chi-square (c2) was used to test the association between the perinatal mortality and the study variables. Variables significant at p < 0.25 were included in multilevel hierarchical analysis to identify the predictors of perinatal mortality. random variability in perinatal mortality across clusters was estimated using the intra-class correlation coefficient (ICC), proportional change in variance (PCV), and median odds ratio (MOR). Predictor variables significant at p £ 0.05 at a 95% confidence interval were reported. Results: The prevalence of perinatal mortality was 27.5/1000 births. Multilevel fixed results showed infants who reported having a fever had a significantly higher likelihood of perinatal mortality, with the odds increasing by approximately 199.1% (aOR = 2.991, 95% CI: 2.128 - 4.202). Women aged 20-24 had 57.4% lower odds of perinatal mortality compared to those aged 15-19 (aOR = 0.442, 95% CI: 0.217 - 0.898, p < 0.05). Cohabiting mothers (aOR = 2.364, 95% CI: 1.035 - 5.401, p < 0.05) and widowed mothers (aOR = 4.703, 95% CI: 1.247 - 17.742, p < 0.05) had significantly higher odds of perinatal mortality compared to mothers who had never been married. Conclusion: This study identifies key predictors of perinatal mortality in Ghana using Andersen’s model, emphasizing predisposing (maternal age, marital status, infant fever), enabling (healthcare access), and need factors (birth weight, pregnancy interval). It is therefore important to prioritize neonatal infection control, targeted support for high-risk mothers and improved ANC quality. Addressing these factors will help reduce preventable perinatal deaths in Ghana.