Socio Demographic Determinants of Maternal Health Service Utilization among Women 15 to 49 Years in Zambezi District in Northwestern Zambia

Abstract

Maternal mortality recorded in Zambia is one of the highest in the world. According to the 2013-14 Zambia Demographic and Health Survey , the mortality ratio was 398/100,000.This ratio is unacceptably high. The aim of this study was to assess the effect of socio demographic factors on utilization of maternal health care services. A cross sectional study of the utilization of maternal health services was carried out among 400 women of child bearing age from 15 to 49 years in Zambezi district in north-west Zambia after having received ethical approval from the Eres Converge research ethics committee. Multistage systematic sampling was done from the 12 clinics' catchment areas in the district. To estimate the effect of the socio-demographic variables on maternal health service utilization three outcome variables were used, which were; use of antenatal care services, assisted (facility) delivery and postnatal care services. Logistic regression was used to estimate models of the outcome variables. The results showed that 38.5 percent (154) of the women received antenatal care, 32.3 percent (129) of the women received delivery services while 48.3 percent (193) received postnatal care services. In the logistic regression model, reduced income level was associated with decreased use of antenatal care (OR=0.1, P<0.05). In assisted delivery, increased distance to the health facility was associated with reduced use (OR=0.1, P <0.05). In postnatal care, reduced education level of the respondent was found to be associated to decreased use of postnatal services (OR=0.51, P<0.05). Increased maternal age was associated with increased utilization of maternal health services (OR=2.1, P<0.05). On the other hand, decision making roles by the male spouse alone or both partners was associated with increased use of postnatal services (OR=4.5,P<0.05). In conclusion, to increase women's utilization of health care services and improve maternal health in Zambia, some crucial steps should be taken on educating women such as integrating of reproductive health programs in the school curriculum. Attention should be given to scaling up male involvement in order to ensure there is understanding of the importance of maternal health services. There is need to strengthen the linkage of postnatal services to under-five services to improve coverage of postnatal services.