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influe,lced the decision of these women t o de1:l.ver at this
institution. Selection bias, limits the generalisation of
s t u dy results.
The Komia Anokye hos pit a l however, is the only public
ge neral hospital i n t he Kumasl district; all other hospitals
are either private or semi -private . I t also handles about 60'
of all de l iveries i n the district and therefore an argument
can be mad e that t he s t u d y sample i s repre sentative of the
great ma jor i t y o f mother.s, in t he general pub j I o of xu e a s L.
Del i v e r i e s i n the district on t he other ha nd a l so occur
at home , in private maternity homes, and i n t wo ather smal l
government hea lth institutions in t h e district: . certainl y the
40% of women who have their babies at these centres ml.'st
differ from the users o f the xcnro Anokye hospital. \'li th the
exc e ption o f the approximatel y 20% o f women who deliver at
home , there is p r oba b l y little difference in the quality of
de l i v ery c a r e received by the ot her 20 \ of women who deliver
at thes e other delivery centres. They t oo are r outinely
disc h ar ge d home wi thin 24 hour's of delivery .
The general tre nd i n the country i s also for most women t o
seek e ntenecej. care equally but to differ more markedly in
their choice of delivery place. If we consider t h i s
observation then it i s also likely that the s ampl e i n t h i s
study will be similar to these other women by t heir pregnancy
and antenatal care characteristics .