Inter-country Variation Research Articles

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care: a qualitative study in three sub-Saharan African countries

ObjectivesTo understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries.DesignA qualitative interview study. The interviews were audiorecorded, transcribed...

Global burden and socioeconomic impact of knee osteoarthritis: a comprehensive analysis.

To report the trend changes of the prevalence, incidence, and disability-adjusted life years (DALYs) of knee osteoarthritis (KOA) according to age, sex, sociodemographic index (SDI), and income. This analysis used estimates from the broader Global Burden of Disease (GBD) study 2019, which covered 201 countries from 1990 to 2019. National prevalence, incidence, and DALYs were shown by using ggplot2 and maps packages. Five-year intervals were used for age groupings. The Commonwealth and the World Bank income classifications were used for income grouping. Globally, there were ~364.58 million prevalent cases (females: 225.16 million), 29.51 million incident cases (females: 17.53 million), and 11.53 million DALYs (females: 7.09 million) due to KOA in 2019. The Western Pacific Region had a high endemicity of ~7,319.87 cases per 100,000 people (7.64%). Japan's prevalence rate (12,610.12 cases per 100,000 population) was 10 times that of Somalia (1,178.23) in 2019. In 200 countries (except the United Arab Emirates), the prevalence, incidence, and DALY rates of KOA in 2019 were higher among females than among males and increased with age up to the oldest age group. The prevalence was highest in the high-middle SDI countries, and the incidence and DALYs were highest in the middle SDI countries. There was a large burden of KOA worldwide, with some notable intercountry variation. Some countries had 10 times the burden of other countries. Increasing population awareness regarding the prevalence, incidence, and DALYs of KOA with a focus on the population in the Western Pacific Region is needed, particularly for older females. informs health policy development, and contributes to improving the efficiency, equity, and effectiveness of healthcare systems.

Variation of practice in the treatment of pyogenic spondylodiscitis: a European Association of Neurosurgical Societies Spine Section study.

The incidence of spondylodiscitis is rising across Europe, but the ideal treatment approach remains controversial. The choice between conservative and surgical therapies is ambiguous due to a lack of consensus. This European survey aimed to explore prevailing treatment paradigms for primary spondylodiscitis. Spine neurosurgeons were invited through the European Association of Neurosurgical Societies Spine Section's mailing list to participate in an online survey featuring 7 spondylodiscitis case vignettes. Along with general management queries, specific patient treatment questions were posed. Data analysis was performed using R software (version 4.0.4). The index of qualitative variation (IQV) was calculated to quantify the variability in responses. A total of 130 responses were collected, comprising 86.9% board-certified neurosurgeons and 13.1% neurosurgeons in training, with an average of 11 years of practice. Most respondents performed 50-100 spine surgeries annually, with 66.7% specializing in spine surgery. An epidural empyema causing pronounced neurological deficits influenced 95.4% toward a surgical intervention, and mild neurological deficits and challenges in pathogen identification prompted 72.3% and 80%, respectively, to consider a surgical approach. Vertebral body destruction and spinal deformity directed 60% and 66.2%, respectively, toward surgery, whereas advanced age and comorbidities had a much smaller impact-5.4% and 9.2%, respectively. Clinical vignettes highlighted a predominant preference for conservative treatment in specific cases, with statistical significance (p < 0.05). The IQV values evaluated for each question ranged from 0.88 to 0.99, indicating low agreement across all questions among respondents. When examining the average IQV by country, intercountry variations in IQV were substantial, as illustrated by the diverse range of overall mean IQV values (0.15-0.85). The findings reveal a significant variability in the treatment of spondylodiscitis among European neurosurgeons, with most neurosurgeons opting for conservative treatment. These diverse strategies, both between and within countries, highlight an imperative for evidence-backed guidelines and consensus statements for this grave condition.

Recognition and management of children and adolescents with conduct disorder: a real-world data study from four western countries

BackgroundConduct disorders (CD) are among the most frequent psychiatric disorders in children and adolescents, with an estimated worldwide prevalence in the community of 2–4%. Evidence-based psychological outpatient treatment leads to significant improvement in about two-thirds of cases. However, there seems to be considerable variation in rates of CD diagnoses and implementation of evidence-based interventions between nations. The aim of this study was to compare administrative prevalence and treatment patterns for CD in children and adolescents seen in health care systems across four Western countries (Denmark, Germany, Norway, and the USA).MethodsCross-sectional observational study using healthcare data to identify children and adolescents (aged 0–19 years) with an ICD-10 code for CD within the calendar year 2018. Within each country’s study population, the prevalence of CD, psychiatric comorbidity, psychopharmacological treatment, and psychiatric hospitalisation was calculated.ResultsThe prevalence of diagnosed CD differed 31-fold between countries: 0.1% (Denmark), 0.3% (Norway), 1.1% (USA) and 3.1% (Germany), with a male/female ratio of 2.0–2.5:1. The rate of psychiatric comorbidity ranged from 69.7 to 86.1%, with attention-deficit/hyperactivity disorder being most common. Between 4.0% (Germany) and 12.2% (USA) of youths with a CD diagnosis were prescribed antipsychotic medication, and 1.2% (Norway) to 12.5% (Germany) underwent psychiatric hospitalisation.ConclusionRecognition and characteristics of youths diagnosed with CD varied greatly by country. In some countries, the administrative prevalence of diagnosed CD was markedly lower than the average estimated worldwide prevalence. This variation might reflect country-specific differences in CD prevalence, referral thresholds for mental health care, diagnostic tradition, and international variation in service organisation, CD recognition, and availability of treatment offers for youths with CD. The rather high rates of antipsychotic prescription and hospitalisation in some countries are remarkable, due to the lack of evidence for these therapeutic approaches. These findings stress the need of prioritising evidence-based treatment options in CD. Future research should focus on possible reasons for inter-country variation in recognition and management of CD, and also address possible differences in patient-level outcomes.

Rates of tree cover loss in key biodiversity areas on Indigenous Peoples' lands.

Indigenous Peoples' lands (IPL) cover at least 38millionkm2 (28.1%) of Earth's terrestrial surface. These lands can be important for biodiversity conservation. Around 20.7% of IPL intersect areas protected by government (PAs). Many sites of importance for biodiversity within IPL could make a substantial but hitherto unquantified contribution to global site-based conservation targets. Key Biodiversity Areas (KBAs) represent the largest global network of systematically identified sites of high importance for biodiversity. We assessed the effectiveness of IPL in slowing biodiversity loss inside and outside PAs by quantifying tree cover loss from 2000 to 2019 in KBAs at international and national levels and comparing it with losses at equivalent sites outside mapped IPL. Based on a matched sample of 1-km2 cells in KBAs inside and outside mapped IPL, tree cover loss in KBAs outside PAs was lower inside IPL than outside IPL. By contrast, tree cover loss in KBAs inside PAs was lower outside IPL than inside IPL (although the difference was far smaller). National rates of tree cover loss in KBAs varied greatly in relation to their IPL and PA status. In one half of the 44 countries we examined individually, there was no significant difference in the rate of tree cover loss in KBAs inside and outside mapped IPL. The reasons for this intercountry variation could illuminate the importance of IPL in meeting the Convention on Biological Diversity's ambition of conserving 30% of land by 2030. Critical to this will be coordinated action by governments to strengthen and enforce Indigenous Peoples' rights, secure their collective systems of tenure and governance, and recognize their aspirations for their lands and futures.

Global Neuropsychopharmacological Prescription Trends in Adults with Schizophrenia, Clinical Correlates and Implications for Practice: A Scoping Review.

It is important to examine the psychotropic prescription practices in schizophrenia, as it can inform regarding changing treatment choices and related patient profiles. No recent reviews have evaluated the global neuropsychopharmacological prescription patterns in adults with schizophrenia. A systematic search of the literature published from 2002 to 2023 found 88 empirical papers pertinent to the utilization of psychotropic agents. Globally, there were wide inter-country and inter-regional variations in the prescription of psychotropic agents. Overall, over time there was an absolute increase in the prescription rate of second-generation antipsychotics (up to 50%), mood stabilizers (up to 15%), and antidepressants (up to 17%), with an observed absolute decrease in the rate of antipsychotic polypharmacy (up to 15%), use of high dose antipsychotic (up to 12% in Asia), clozapine (up to 9%) and antipsychotic long-acting injectables (up to 10%). Prescription patterns were mainly associated with specific socio-demographic (such as age), illness (such as illness duration), and treatment factors (such as adherence). Further work, including more evidence in adjunctive neuropsychopharmacological treatments, pharmaco-economic considerations, and examination of cohorts in prospective studies, can proffer insights into changing prescription trends relevant to different treatment settings and predictors of such trends for enhancement of clinical management in schizophrenia.

Armed Conflicts and Household Socioeconomic Status in the Lake Chad Basin: A Random Coefficient Model Approach

Abstract This study extends the existing literature on the relationship between armed conflicts and the socioeconomic status of households in Lake Chad Basin (LCB) countries by adopting a random coefficient model to analyse micro-panel data covering the 1997–2020 periods. The random coefficient approach allows for country-specific effects in explaining variations in both the nature and degree of the effects of conflict due to differing country characteristics. The result evidenced a significant negative effect of the average impact of armed conflict on poverty, while the coefficient of educational outcome is insignificant. The country-specific results point to significant inter-country variations in the impact of armed conflicts on poverty and education outcomes. The descriptive statistics result shows that the inter-country variations could be attributed to differing quality of institutions. Finally, environmental degradation and macroeconomic uncertainties do not appear to bear a systematic relationship with householdsʼ level of socioeconomic status in the Lake Chad Basin. These findings indicate that a uniform and blanket adoption of public policies by government in Lake Chad Basin countries will not yield a significant positive result. Therefore, governments, practitioners and academicians should contextualise policies/recommendations meant to improve socioeconomic status of households in conflict, while strengthening the quality of institutions to ameliorate the impact of conflict on socioeconomic status (SES) of households.

The cardiovascular disease burden attributable to low physical activity in the Western Pacific Region, 1990-2019: an age-period-cohort analysis of the Global Burden of Disease study.

To increase the comprehensive understanding of trends in the burden of cardiovascular disease (CVD) attributable to low physical activity in the Western Pacific Region. Based on data from the Global Burden of Disease study for the years 1990-2019, an age-period-cohort analysis was conducted to investigate trends in CVD-related mortality attributable to low physical activity in the Western Pacific Region and associations with age, period, and birth cohort. We also used joinpoint regression analysis to identify the periods with the most substantial changes. The results show that, the Western Pacific Region witnessed a substantial increase in CVD deaths attributable to low physical activity, accompanied by a rise in all-age CVD-related mortality. However, the age-standardized death rate was lower in the region than the global level, highlighting the importance of considering the age composition of CVD burden in the region. Countries with higher socio-demographic index (SDI) levels exhibited lower mortality than those with lower SDI levels. The longitudinal analysis using the age-period-cohort model indicated an overall improvement in CVD-related mortality attributable to low physical activity in the region, but with differences between sexes and CVD subtypes. Specific period in which CVD-related mortality decreased significantly was 2011-16, for the average annual percentage change for the period was -0.69%. The study highlights the significance of addressing low physical activity as a modifiable risk factor for CVD burden in the Western Pacific Region. Further research is essential to understand the factors contributing to inter-country variations, sex disparities, and CVD subtypes distinctions.

Large Discrepancies in Dementia Mortality Reported in Vital Statistics: The Need for Improved Data to Inform Policy.

There is limited understanding of the intercountry comparability of dementia mortality data. This study compares reported dementia mortality in national vital statistics between countries and over time. In countries with low dementia reporting, this study identifies other causes to which dementia may be misclassified. Using the World Health Organization (WHO) Mortality Database, we calculated the ratio of reported to expected (Global Burden of Disease estimated) age-standardized dementia death rates in 90 countries from 2000 to 2019. Other causes to which dementia may be misclassified were identified as having relatively high cause fractions compared with other countries. No patients were involved. There is a large intercountry variation in reported dementia mortality rates. The ratio of reported to expected dementia mortality exceeded 100% in high-income countries but was below 50% in other super regions. In countries with low reported dementia mortality, cardiovascular diseases, ill-defined causes, and pneumonia have relatively high cause fractions and may be misclassified from dementia. Large discrepancies in dementia mortality reporting between countries, including often implausibly low reported mortality, makes comparison extremely difficult. Improved guidance for and training of certifiers and the use of multiple cause-of-death data can help strengthen the policy utility of dementia mortality data.

Second Generation Basal Insulin, Degludec, in the Management of Diabetes; Consensus Report

The best anti-diabetic medication does, in fact, have a low propensity to increase body weight and rate of hypoglycemia as well as glycemic control. The second-generation basal insulins analogues insulin degludec and insulin glargine 300 units/mL have significantly longer half-life and substantially smoother profiles than firstgeneration. The duration of action of glargine 300 is shorter than that of degludec, and significant residual glycemic variability is still present. Degludec has lower risks of hypoglycemia. Evaluating the therapeutic application in various geographical contexts is necessary, given the inter-country variations in the prescription patterns of glucose-lowering medications for persons with diabetes. A Saudi task force gathered to develop an explicit, evidence-based consensus for insulin degludec utilization in the local setting. This work contains the expert panel's recommendations as a contribution to complement the knowledge gap in this area from the national perspective. Results of the local UPDATES study investigating the treatment effect of degludec in adults with T2DM in Saudi Arabia showed that patients treated with degludec experienced clinically significant improvements in glycaemic control and a lower rate of hypoglycemia compared to baseline, with no new safety concerns. Results confirm that previously published data with degludec are generalizable to a broad population of patients with T2DM in routine clinical practice in Saudi Arabia. Moreover, local cost-utility analyses of degludec versus glargine 300 in T1DM and T2DM showed that it is cost-saving. Degludec was associated with less cost with better quality of life. Thus, the reimbursement of degludec will have a positive impact on the budget.

Transactional-governance structures:new cross-country data and an application to the effect of uncertainty

Abstract To what extent are personal trust, mutual interests, and third parties important in enforcing agreements to trade? How do firms combine these to form transactional-governance structures? This article answers these questions in a whole-economy, cross-country setting that considers a full spectrum of transactional-governance strategies. The data collection requires a new survey question answerable in any context. The question is applied in six South American countries using representative samples, with the resultant survey weights facilitating a whole-economy analysis. Without imposing an a priori model, latent class analysis estimates meaningful governance structures. Bilateralism is always used. Law is never used alone. Bilateralism and formal institutions are rarely substitutes. Within country, inter-regional variation in governance is greater than inter-country variation. The usefulness of the data is shown by testing one element of Williamson’s discriminating-alignment agenda: greater uncertainty in the transactional environment increases the involvement of third parties.

Family Planning Progress in 113 Countries Using a New Composite Progress Index

This paper analyses family planning progress in 113 countries in the context of meeting the demand for family planning through a composite progress index that measures progress in three dimensions – demand for permanent methods, demand for modern spacing methods and expansion of method choice – following the progress triangle approach. This paper suggests that in more than forty per cent of countries analysed, family planning progress remains far from satisfactory in meeting the family planning demand and there is substantial inter-country variation in the progress. In some countries, progress appears to have reversed. The inter-country variation in family planning progress is primarily the result of inter-country variation in meeting the demand for permanent methods. The analysis calls for the reinvigoration of family planning efforts to meet the target set under the United Nations 2030 Sustainable Development Agenda and the FP2030 initiative.

Physical Examination of Potential Deceased Organ and Tissue Donors: An Overview of the European Landscape.

Physical examination (PE) of donors is essential to identify potential risks to the safety and efficacy of donated organs and tissues and is mandatory in the EU. However, no detailed guidance is available as to how PE should be performed. Health authorities (HA) and health professionals (HP) in member states of the European Committee on Organ Transplantation of the Council of Europe (CD-P-TO) and observer countries completed surveys relating to the regulatory requirements for PE and the professional practice of PE in their countries for organ and tissue donors. The HA survey addressed regulatory aspects, and the HP survey addressed professional practices, training, and respondents' opinions on the value of PE. These surveys revealed significant inter-country variation in the regulatory approach to PE and the performance of PE by professionals. Most respondents opined that PE was important and yielded valuable information in identifying contraindications to donation. There is no consensus at a regulatory or professional level as to how PE should be performed on organ and tissue donors. There is a requirement for agreed best practice guidelines in this area.

Access to medical care and its association with physical injury in adolescents: a cross-national analysis

BackgroundStrong variations in injury rates have been documented cross-nationally. Historically, these have been attributed to contextual determinants, both social and physical. We explored an alternative, yet understudied, explanation for variations...

Understanding International Variations in Kidney Failure Incidence and Initiation of Replacement Therapy

Incidence of kidney replacement therapy (KRT) varies widely across countries. Its relations to individual characteristics, nephrology practices for slowing chronic kidney disease (CKD) progression, and KRT access remain unclear. We investigated intercountry differences in kidney failure (KF) rate, defined by a sustained estimated glomerular filtration rate (eGFR)<15 ml/min per 1.73 m2, and separately in KRT incidence, before and after adjusting for risk factors and blood pressure (BP) control or renin-angiotensin-aldosterone system inhibitor (RAASi) prescription practices in the CKD Outcomes and Practice Patterns Study (CKDopps) cohort study. Among 7381 patients with CKD stage 3 to 4 at enrollment, 1297 progressed to KF and 947 initiated KRT over a 3-year follow-up period. Compared to the United States, demographic-adjusted and eGFR-adjusted hazard ratios (HRs) (HRs, 95% confidence intervals [CI]) for a sustained low eGFR were 0.77 (95% CI, 0.57-1.02) in Brazil, 0.90 (95% CI, 0.75-1.08) in France, and 1.03 (95% CI, 0.86-1.03) in Germany. Further adjustment for comorbidities, albuminuria, systolic BP, and RAASi prescription did not substantially change these HRs. In contrast, compared with the United States, the fully-adjusted HR for KRT remained significantly lower in Brazil (0.55, 95% CI 0.39-0.79), higher in Germany (95% CI, 1.36, 1.09-1.69), and similar in France (95% CI, 1.07, 0.81-1.39). Individual risk factors for CKD progression in nephrology patients appeared to explain most intercountry variations in KF but not KRT incidence. This suggests a prominent role for differences in practices related to KRT initiation or access, but not those for slowing disease progression. This study also shows that using KRT as a KF surrogate may bias estimates of associations with CKD progression risk factors.

The Burden of Gout and Its Attributable Risk Factors in the Middle East and North Africa Region, 1990 to 2019.

This study reported the burden of gout and its attributable risk factors in the Middle East and North Africa (MENA) region between 1990 and 2019 by age, sex, and sociodemographic index (SDI). Data on the prevalence, incidence, and years lived with disability (YLD) due to gout were obtained from the Global Burden of Disease 2019 study for the 21 countries in the MENA region, from 1990 to 2019. In 2019, the regional age-standardized point prevalence and annual incidence rates of gout were 509.1 and 97.7 per 100,000 population, which represent a 12% and 11.1% increase since 1990, respectively. Moreover, in 2019 the regional age-standardized YLD rate was 15.8 per 100,000 population, an 11.7% increase since 1990. In 2019, Qatar and Afghanistan had the highest and lowest age-standardized YLD rates, respectively. Regionally, the age-standardized point prevalence of gout increased with age up to the oldest age group, and it was more prevalent among males in all age groups. In addition, there was an overall positive association between SDI and the burden of gout between 1990 and 2019. In 2019, high BMI (46.1%) was the largest contributor to the burden of gout in the MENA region. There were large intercountry variations in the burden of gout, but in general, it has increased in MENA over the last 3 decades. This increase is in line with the global trends of gout. However, the age-standardized YLD rate change was higher in MENA than at the global level.

Inter-Country COVID-19 Contagiousness Variation in Eight African Countries.

The estimates of contiguousness parameters of an epidemic have been used for health-related policy and control measures such as non-pharmaceutical control interventions (NPIs). The estimates have varied by demographics, epidemic phase, and geographical region. Our aim was to estimate four contagiousness parameters: basic reproduction number (R0), contact rate, removal rate, and infectious period of coronavirus disease 2019 (COVID-19) among eight African countries, namely Angola, Botswana, Egypt, Ethiopia, Malawi, Nigeria, South Africa, and Tunisia using Susceptible, Infectious, or Recovered (SIR) epidemic models for the period 1 January 2020 to 31 December 2021. For reference, we also estimated these parameters for three of COVID-19's most severely affected countries: Brazil, India, and the USA. The basic reproduction number, contact and remove rates, and infectious period ranged from 1.11 to 1.59, 0.53 to 1.0, 0.39 to 0.81; and 1.23 to 2.59 for the eight African countries. For the USA, Brazil, and India these were 1.94, 0.66, 0.34, and 2.94; 1.62, 0.62, 0.38, and 2.62, and 1.55, 0.61, 0.39, and 2.55, respectively. The average COVID-19 related case fatality rate for 8 African countries in this study was estimated to be 2.86%. Contact and removal rates among an affected African population were positively and significantly associated with COVID-19 related deaths (p-value < 0.003). The larger than one estimates of the basic reproductive number in the studies of African countries indicate that COVID-19 was still being transmitted exponentially by the 31 December 2021, though at different rates. The spread was even higher for the three countries with substantial COVID-19 outbreaks. The lower removal rates in the USA, Brazil, and India could be indicative of lower death rates (a proxy for good health systems). Our findings of variation in the estimate of COVID-19 contagiousness parameters imply that countries in the region may implement differential COVID-19 containment measures.

Relationship between Alcohol and Homicide, in Nairobi County, Kenya: Autopsy Study.

This study sought to investigate the relationship between alcohol and homicide, in Nairobi County, Kenya. The study was carried out at the city Mortuary, Nairobi. In this study, all cases of violent deaths for a period of twelve consecutive months were included. Alcohol level estimation was done on 400 of all the study subjects. The 400 were selected consecutively as every fifth subject. This was a purposeful sampling frame and size. The data obtained included age and gender distribution, type of accident, when the accident occurred and the alcohol levels of the deceased. This data was analysed using SPSS. The study concludes that homicide is a preventable public health problem and a major contributor to violent deaths. Moderate and heavy intoxication predispose to homicide. Deaths from accidents were largely those caused by burns and drowning; they were positively correlated with alcohol intake and are a preventable public health problem in Kenya. The study recommends that public policy should educate the public on this phenomenon that relates homicide to alcohol intoxication. Violence causing fatal trauma to the body, the commonest cause of unnatural death, is a preventable leading global public health problem. Further, it shows intercountry and intercity variation. Its prevention and control require data on the magnitude and nature of the problem.

Invasive Species in Post-2020 Global Environmental Politics

Abstract As goods and people more rapidly traverse our interconnected world, invasive alien species (IAS) are increasingly frequent, ecologically damaging, economically significant, and culturally concerning. Through examinations of IAS, global environmental politics (GEP) scholars can more deeply engage long-standing and newly emerging research problems within the three areas of global governance, global political economy, and environmental security. First, GEP scholars can use IAS research to further develop insights about the impact of problem structure on global governance. Second, examining IAS dispersal risks and associated costs, as well as intercountry variation in management responses, can generate insights about North–South power dynamics in the global political economy and how distributive conflict is likely to shape future invasion risk. Third, notions of environmental security in GEP scholarship can be challenged and further developed by examining the conceptualization and operationalization of “biosecurity” amid increasingly diverse multispecies assemblages. Greater research attention to IAS in GEP is long overdue, and we intend for this article to open novel pathways for GEP interdisciplinary research on IAS.

Prevalence and determinants of maternal healthcare utilisation among young women in sub-Saharan Africa: cross-sectional analyses of demographic and health survey data

BackgroundMaternal health constitutes high priority agenda for governments across the world. Despite efforts by various governments in sub-Saharan Africa (SSA), the sub-region still records very high maternal mortality cases. Meanwhile, adequate utilization of maternal healthcare (antenatal care [ANC], skilled birth attendance [SBA], and Postnatal care [PNC]) plays a vital role in achieving improved maternal health outcomes. We examined the prevalence and determinants of maternal healthcare utilization among young women in 28 sub-Saharan African countries using data from demographic and health surveys.MethodsThis was a cross-sectional study of 43,786 young women aged 15–24 years from the most recent demographic and health surveys of 28 sub-Saharan African countries. We adopted a multilevel logistic regression analysis in examining the determinats of ANC, SBA, and PNC respectively. The results are presented as adjusted Odds Ratios (aOR) for the logistic regression analysis. Statistical significance was set at p < 0.05.ResultsThe prevalence of maternal healthcare utilisation among young women in SSA was 55.2%, 78.8%, and 40% for ANC, SBA, and PNC respectively with inter-country variations. The probability of utilising maternal healthcare increased with wealth status. Young women who were in the richest wealth quintile were, for instance, 2.03, 5.80, and 1.24 times respectively more likely to utilise ANC (95% CI = 1.80–2.29), SBA (95% CI = 4.67–7.20), and PNC (95% CI = 1.08–1.43) than young women in the poorest wealth quintile. Young women who indicated having a barrier to healthcare utilisation were, however, less likely to utilise maternal healthcare (ANC: aOR = 0.83, 95% CI = 0.78–0.88; SBA: aOR = 0.82, 95% CI = 0.75–0.88; PNC: aOR = 0.88, 95% CI = 0.83–0.94).ConclusionWhile SBA utilisation was high, we found ANC and PNC utilisation to be quite low among young women in SSA with inter-country variations. To accelerate progress towards the attainment of the Sustainable Development Goal (SDG) targets on reducing maternal mortality and achieving universal health coverage, our study recommends the adoption of interventions which have proven effective in some countries, by countries which recorded low maternal healthcare utilisation. The interventions include the implementation of free delivery services, training and integration of TBAs into orthodox maternal healthcare, improved accessibility of facilities, and consistent public health education. These interventions could particularly focus on young women in the lowest wealth quintile, those who experience barriers to maternal healthcare utilisation, uneducated women, and young women from rural areas.