Perceived behavioral factors relating to maternal health service utilization intention in rural Sefwi Wiawso Municipality, Ghana

Despite global and national efforts to increase access to maternal health services, rural communities in Ghana continue to face challenges in service utilization. While systemic and structural barriers are well documented, a critical gap in the literature regarding the role of behavioral factors and their relationship to maternal mortality rates remains. This study, therefore, identified the perceived behavioral factors related to pregnant women’s intention to utilize essential services, including antenatal care, skilled birth attendance, and postnatal care, in a rural setting. A cross-sectional survey design was employed. Data were collected from an allocated sample of 279 eligible women using a structured questionnaire. The findings revealed a high level of maternal health service utilization intention (M = 4.03, SD = .82). Participants demonstrated high levels for maternal attitude (M = 3.95), perceived social norm (M = 3.96, SD = .79), and perceived self-efficacy (M = 4.01, SD = .72). Results showed strong and statistically significant positive correlations between all three behavioral constructs and utilization intention (p < .01). Moreover, the study found a significant difference on scores for residence and monthly income related to maternal health intention and all behavioral constructs (p < .001), while scores on educational level and occupation showed significant difference with scores on attitude, self-efficacy, and utilization intention (p < .001). Conversely, parity showed a significant difference with attitude, age with self-efficacy, while mode of transport and walking distance were primarily different with scores on utilization intention and social norms (p < .05). Marital status was significantly different with maternal self-efficacy (p < .011). Maternal attitude (β = .300, p < .001), social norms (β = .214, p < .001), and self-efficacy (β = .492, p < .001) were all significant predictors of intention, with self-efficacy emerging as the strongest predictor. The study concludes that maternal health service utilization intention in rural Sefwi Wiawso is significantly associated with behavioral factors. Perceived self-efficacy was the strongest predictor among the variables tested. It is recommended that maternal health programs prioritize strategies that strengthen women’s self-efficacy and address the social norms correlated with healthcare-seeking intentions.