Availability of Water and Utilization of Skilled Delivery in Maternity Wards: A Quasi-Experimental Study in Talensi and East Mamprusi Districts

Maternal mortality continues to be a major public health concern in northern Ghana which is partly ascribed to socio-cultural limitations coupled with poor accessibility to safe maternal delivery services. The availability of safe water in hospital maternity units is crucial for infection prevention, facility readiness, and patient satisfaction. But many health facilities in rural areas don’t have reliable access to water. Clean and safe water, adequate toilets, good hygiene practice, and enough water to wash and for waste disposal at care point hand hygiene facilities and at the toilet are essential services under WHO WASH in HCF standards. This quasi-experimental, mixed approaches research aim at assessing the effects of water supply on utilization of skilled delivery services in Talensi and East Mamprusi District. Recruitment of 840 women aged 15–49 who visited selected facilities for delivery between December 2020 and January 2025 was undertaken, with information from midwives and facility managers added. The facilities were grouped into intervention (mechanized boreholes) and control (no sustained source of water). Quantitative data were conducted using SPSS and STATA, including chi-square testing, logistic regression analysis, multi-level model analysis and propensity score matching. Qualitative interview data were analyzed using thematic analysis. Results: Intervention centers were better prepared in readiness components such as hygiene, sterility and cleanliness. At intervention sites, skilled attendance was more common 15 percentage points and water access doubled the odds of SBA (OR = 1.92, CI: 1.35–2.73). These quantitative findings were echoed by qualitative data with mothers’ focus on safety and dignity in water delivering wards, while staff spoke of improvements in timeliness and infection control. Consistent access to clean water supports adoption of maternal health services. The link between water and health is particularly pertinent for maternal health: as such, WASH in maternity wards should be a priority area for policymakers, and progress towards improvements in maternal health should be monitored through the lens of water-access indicators. Additional research is needed in other districts and should include cost-benefit analyses of neonatal outcomes. Clean water at birth is the cornerstone of dignity and life-saving results.