Sociodemographic Determinants of Health Facility Delivery, Cesarean Section, and Postnatal Care Utilization in Ghana: A Scoping Review

Background: Utilization of maternal health services, including health facility delivery (HFD), cesarean delivery (CD), and postnatal care (PNC), remains suboptimal in Ghana despite the implementation of the free maternal healthcare policy. Sociodemographic factors have been recognized as key determinants influencing women’s engagement with these services. This scoping review synthesizes evidence on the role of sociodemographic factors in shaping maternal health service utilization in Ghana. Methods: We conducted a scoping review of peer-reviewed studies published in Ghana between July 2008 and July 2019 that examined the association between sociodemographic factors and maternal health service utilization. Databases searched included PubMed, Medline, Embase, Cochrane Central, African Journals Online, and Global Health. Eligible studies reported associations between maternal age, marital status, parity, place of residence, religion, ethnicity, education, employment status, and wealth status with HFD, CD, or PNC. Data were extracted and synthesized thematically to identify patterns and variations across studies. Results: Eleven studies met the inclusion criteria. Wealth status consistently emerged as a strong determinant, with women from higher wealth quintiles more likely to access HFD, CD, and PNC services. Education, parity, maternal age, marital status, employment status, place of residence, religion, and ethnicity showed variable associations across studies. HFD was predominantly influenced by wealth and education, though findings for parity and place of residence were inconsistent. CD uptake was positively associated with higher maternal age and wealth, whereas PNC utilization was influenced by ethnicity, employment, and education, with mixed results for maternal age and marital status. Variations in study design, sample size, and regional context likely contributed to inconsistencies. Conclusion: Sociodemographic factors, particularly wealth and education, significantly affect maternal health service utilization in Ghana. Persistent disparities underscore the need for targeted interventions to improve equity and access. Future research employing nationally representative data is essential to clarify these determinants and inform evidence-based policies aimed at increasing uptake of HFD, CD, and PNC services.