Abstract
Reducing the maternal mortality ratio (MMR) in low- and middle-income countries (LMICs) remains a huge challenge. Maternal mortality is mostly attributed to low coverage of maternal health services. This study investigated the trajectories and predictors of skilled birth attendant (SBA) service utilisation in LMIC over the past two decades. The data was sourced from standard demographic and health surveys which included four surveys on women with livebirth/s from selected countries from two regions with a pooled sample of 56,606 Indonesian and 63,924 Nigerian respondents. Generalised linear models with quasibinomial family of distributions were fitted to investigate the association between SBA utilisation and sociodemographic factors. Despite a significant improvement in the last two decades in both countries, the change was slower than hope for, and inconsistent. Women who received antenatal care were more likely to use an SBA service. SBA service utilisation was significantly more prevalent amongst literate women in Indonesia (AOR = 1.39, 95% CI: 1.24–1.54) and Nigeria (AOR = 1.41, 95% CI: 1.31–1.53) than their counterparts. The disparity based on geographic region and social factors remained significant over time. Given the significant disparities in SBA utilisation, there is a strong need to focus on community- and district-level interventions that aim at increasing SBA utilisation.
Highlights
Maternal mortality is unacceptably high in the low- and middle-income countries (LMICs) around the globe
Of the women of reproductive age who had at least one live birth within five years preceding each survey, about half of the Indonesian participants were aged between 15 and 29 (50.1%) and just over half lived in rural areas (53.2%)
In line with the findings of other studies, this study revealed that level of education is linked to increased antenatal care (ANC) utilisation and HCF delivery, as better-educated individuals are more knowledgeable of health literacy, and as such are likely to seek higher quality health services [36,38,39]
Summary
Maternal mortality is unacceptably high in the low- and middle-income countries (LMICs) around the globe. Despite being on the global agenda for decades [1], the World. 94% of all maternal deaths occur in LMICs, primarily in. As part of the continued effort to reduce maternal mortality rate (MMR), the Sustainable Development Goals (SDGs) were launched at the United Nations General Meeting (2015b), with SDG 3.1 outlining the reduction of the global MMR to less than 70 per 100,000 live births by 2030 [4]. For example, had an MMR of 177 per 100,000 live births (2017) and has managed to decrease their MMR by an average of 3.1% over the past 10 year (Indonesia Maternal Mortality Rate 2000–2021, 2021), whist Nigeria’s MMR rate in 2017, for example, was 917 per 100,000 live births and has been averaging a decrease of only 0.96% per year over the past 10 years
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