gms | German Medical Science

Introduction: Pakistan is among the countries with high rates of maternal mortality and morbidity. Arguably, the utilization of maternal health care services reduces maternal mortality and improves women’s reproductive health. Nonetheless, determinants of maternal health care services utilization are not the same across socio-economic strata in a given society. In Pakistan, little is known about the current status and determinants of maternal health care services utilization. This paper investigates the association of maternal health care services utilization with individual, household, and community-level factors.

Methods: The study used data from 2006-07 Pakistan Demographic and Heath Survey (DHS), a nationally representative sample of 10,023 women aged 15-49 years. Our analysis was limited to the last live birth during the five years preceding the survey, total of 5724 women. For measuring the maternal health care utilization we used four dependent variables, i.e., use of antenatal care (ANC), use of ANC in the first trimester, delivery assistance by health professionals, and delivery in a medical facility. Multivariable logistic regression analysis was applied to assess the association between maternal health care utilization and socio-demographic variables.

Results: The analysis of data showed that about 64% women received some ANC for their last born child and among them about half received ANC in the first trimester. About 42% received health professionals’ assistance during delivery; only 36.9% delivered in a health care facility. We found that the women’s urban place of residence than rural (Adjusted Odds Ratio [AOR] 1.41, 95% Confidence Interval [CI] 1.20-1.64), women’s level of education i.e., more than ten years of schooling versus no schooling (AOR 5.16, 95%CI 3.18-9.98), high socioeconomic status than low status (AOR 5.69, 95%CI 4.27-7.58), economically developed regions than less developed ones (AOR 2.89, 95%CI 2.25-3.71), having two or less children than five or more children (AOR 2.08, 95%CI 1.83-2.38), and having a history of abortion than no abortion (AOR 1.51, 95%CI 1.25-1.82) were significantly associated with ANC utilization. Similarly, all these variables were significantly associated with ANC utilization in the first trimester, delivery assistance by health professionals, and delivery in a medical facility.

Conclusions: We found that women with high education, living in urban and prosperous areas, having fewer children, and having a history of abortion were more likely to use maternal health care services. The results may be useful for policymakers to develop efficient strategies to improve the health care services utilization in Pakistan.