Abstract
BackgroundEnsuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector. There are significant disparities in maternal health care indicators across many geographical locations, maternal, economic, socio-demographic factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization level of maternal health care, and examined disparities in the determinants of major maternal health outcomes.MethodsThis paper used data from two rounds of Benin Demographic and Health Survey (BDHS) to examine the utilization and disparities in factors of maternal health care indicators using logistic regression models. Participants were 17,794 and 16,599 women aged between15–49 years in 2006 and 2012 respectively. Women’s characteristics were reported in percentage, mean and standard deviation.ResultsMean (±SD) age of the participants was 29.0 (±9.0) in both surveys. The percentage of at least 4 ANC visits was approximately 61% without any change between the two rounds of surveys, facility based delivery was 93.5% in 2012, with 4.9% increase from 2006; postnatal care was currently 18.4% and contraceptive use was estimated below one-fifth. The results of multivariable logistic regression models showed disparities in maternal health care service utilization, including antenatal care, facility-based delivery, postnatal care and contraceptive use across selected maternal factors. The current BHDS showed age, region, religion were significantly associated with maternal health care services. Educated women, those from households of high wealth index and women currently working were more likely to utilize maternal health care services, compared to women with no formal education, from poorest households or not currently employed. Women who watch television (TV) were 1.31 (OR = 1.31; 95% CI = 1.13–1.52), 1.69 (OR = 1.69; 95% CI = 1.20–2.37) and 1.38 (OR = 1.38; 95% CI = 1.16–1.65) times as likely to utilize maternal health care services after adjusting for other covariates.ConclusionThe findings would guide stakeholders to address inequalities in maternal health care services. More so, health care programmes and policies should be strengthened to enhance accessibility as well as improve the utilization of maternal care services, especially for the disadvantaged, uneducated and those who live in hard-to-reach rural areas in Benin. The Benin government needs to create strategies that cover both the supply and demand side factors at attain the universal health coverage.
Highlights
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector
Data extraction Data for this study were derived from two rounds of Demographic and Health Survey in Benin that provided information on antenatal care, institutional delivery and contraceptive use
This study has identified the importance of vital maternal care services and associated socio-demographic, economic and proximate factors disparities against the backdrop of poor maternal health indicators in Benin
Summary
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector. The steps towards achieving the third United Nations (UN) Sustainable Development Goals (SDGs), to reduce maternal morbidity and mortality and achieve universal health coverage to include access to essential health care services by 2030 have been a great issue in developing countries, even with the existence of health care interventions. Developing countries have been reported to account for about 99% of the global maternal mortality, while sub-Saharan Africa (SSA) countries record approximately 62% and having Maternal Mortality Ratio (MMR) of 510 maternal deaths per 100,000 live births [2, 3]. The challenge of unfair distribution of health care services is gaining global attention in the area of public health, with evidence of the disadvantaged sections of the society, having worst health conditions [1]. A country with Total Fertility Rate (TFR) of 5.3, is ranked the 34th in the world with maternal death [4]
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