Predictors of maternal health services uptake in West African region: a multilevel multinomial regression analysis of demographic health survey reports.

Publisher: BioMed Central Country of Publication: England NLM ID: 101224380 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-4755 (Electronic) Linking ISSN: 17424755 NLM ISO Abbreviation: Reprod Health Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Maternal Health Services*; Female ; Pregnancy ; Humans ; Prenatal Care ; Regression Analysis ; Health Surveys ; Demography ; Patient Acceptance of Health Care ; Multilevel Analysis

Background: Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013-2021).
Methods: This study was based on the appended women's (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15-49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into 'no', 'partial', or 'adequate' use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05.
Results: 66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake.
Conclusion: The uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women's autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes.
(© 2024. The Author(s).)

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Keywords: Adequate; Maternal health services; Multilevel; Partial; Predictors; West Africa

Date Created: 20240406 Date Completed: 20240408 Latest Revision: 20240409

20240409

PMC10999082

10.1186/s12978-024-01782-5

38582831