Determinants of maternal health service utilization in Uganda

Abstract

Uganda has through the National Development Plan setout 5 year targets in order to accelerate the reduction in infant mortality which unfortunately this targets have not been met for example, the NDP 3 by 2025 is at 10 deaths per 1000 live births. The main objective of the study therefore was to evaluate the determinants of maternal health service utilization in Uganda using the 2018 nationally representative Uganda Demographic and Health Survey (UDHS). The UDHS data underwent a three tier analysis that is univariate, bivariate and multivariate analyses using SPSS. Findings from the bivariate analysis revealed that that all factors that is demographic health factors significantly influenced maternal health utilization which include age (p = 0.00), region (p = 0.00), though religion did not significantly influence maternal health utilization (p = 0.08> 0.05). It was further revealed that socioeconomic factors also significantly influenced maternal health utilization which include wealth index, residence. It was also revealed that health factors like distance to health facility, visiting health facility also influenced maternal health facility. Using a logistic regression model, Education significantly influenced the utilization of MHC, holding other variables constant, having secondary or higher education increased the relative risk of utilizing desirable category of maternal health services (RRR = 4.5; 95 % CI = 1.514.0).Region of residence was also significantly associated with utilization of the desirable and moderate packages of maternal health services. The relative risk of utilizing desirable MHS package reduced for all other Ugandan regions compared to Kampala, the capital. Eastern Uganda exhibited the lowest log-odds of utilizing the desired category of maternal health services (RRR = 0.2; 95 % CI = 0.1-0.5). Similarly, the relative risk of utilizing moderate package of maternal health services, compared to the undesirable package decreased by a factor of 0.24 (95 % CI = 0.1-0.6) among Muslim women, compared to Catholic women. Furthermore, in comparison to women who were never married women were less likely to utilize the moderate package of maternal health services compared to the undesirable package (RRR = 0.4; 95 % CI = 0.2-0.8). The government and its development partners should ensure universal access to education beyond the primary and secondary level and sensitize communities to the importance of sending all their children particularly girls to school. This will reduce early marriages and empower mothers with both knowledge and means to give quality care to their children.