Abstract
BackgroundUganda’s poor maternal health indicators have resulted from weak maternal health services delivery, including access to quality family planning, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns. This paper investigated the predictors of maternal health services (MHS) utilization characterized as: desirable, moderate and undesirable.MethodsWe used a sample of 1728 women of reproductive ages (15–49), who delivered a child a year prior to the 2011 UDHS survey. A multinomial logistic regression model was used to analyze the relative contribution of the various predictors of ideal maternal health services package utilization. Andersen’s Behavioral Model of Health Services Utilization guided the selection of covariates in the regression model.ResultsWomen with secondary and higher education were more likely to utilize the desirable maternal health care package (RRR = 4.5; 95 % CI = 1.5-14.0), compared to those who had none (reference = undesirable MHS package). Women who lived in regions outside Kampala, Uganda’s capital, were less likely to utilize the desirable package of maternal health services (Eastern – RRR = 0.2, CI = 0.1-0.5; Western – RRR = 0.3, CI = 0.1-0.8; Central – RRR = 0.3, CI = 0.1-0.8; Northern – RRR = 0.4, CI = 0.2-1.0). Women from the richest households were more likely to utilize the desirable maternal health services package (RRR = 1.9; 95 % CI = 1.0-3.7). Residence in rural areas, being Moslem and being married reduced a woman’s chances of utilizing moderate maternal health care services.ConclusionsUtilization of maternal health services varied greatly by demographic and socio-economic characteristics. Women with a secondary and higher education, and those of higher income levels, were more likely to utilize the ideal maternal health services package. Therefore, there is need to formulate policies and design maternal health services programs that target the socially marginalized women.
Highlights
Uganda’s poor maternal health indicators have resulted from weak maternal health services delivery, including access to quality family planning, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns
Women who lived in regions of Uganda other than Kampala were less likely to utilize the desirable package of maternal health services, while women from the affluent households were more likely to utilize the desirable maternal health services package
We aimed at investigating factors that are associated with utilization of maternal health services in Uganda
Summary
Uganda’s poor maternal health indicators have resulted from weak maternal health services delivery, including access to quality family planning, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns. This paper investigated the predictors of maternal health services (MHS) utilization characterized as: desirable, moderate and undesirable. Maternal health is a major global development challenge in Africa, which accounts for about half of the world’s maternal deaths, with little or no progress towards reduction of maternal mortality [1, 2]. Factors associated with maternal mortality in sub-Saharan Africa (SSA) were related to prenatal care coverage and skilled attendance at delivery [1]. Failure to use maternal health services was a key predictor of perinatal death [3]. Postnatal care improves the health of both the newborn and mother. A study conducted in the Ulanga and Kilombero rural Demographic Surveillance sites in south-eastern Tanzania in 2008 [4], showed that poor quality of care, limited awareness about the health benefits of antenatal care, late recognition of pregnancy, and social and economic factors influenced timing of antenatal care [4,5,6]
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