Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023
Background Mozambique has one of the highest maternal mortality rates in sub-Saharan Africa. While some progress has been made, further efforts are required to ensure that women in Mozambique have access to high-quality healthcare. A key strategy for reducing maternal and child mortality is to promo...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/5/e018121.full |
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| author | Sergio Chicumbe Nazeem Muhajarine Fernanda Andre Md Sabbir Ahmed Nahin Shakurun |
| author_facet | Sergio Chicumbe Nazeem Muhajarine Fernanda Andre Md Sabbir Ahmed Nahin Shakurun |
| author_sort | Sergio Chicumbe |
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| description | Background Mozambique has one of the highest maternal mortality rates in sub-Saharan Africa. While some progress has been made, further efforts are required to ensure that women in Mozambique have access to high-quality healthcare. A key strategy for reducing maternal and child mortality is to promote adequate access to and utilisation of maternal healthcare services.Methods We used the population-based, nationwide, cross-sectional Mozambique Demographic and Health Survey 2022–2023 data (n=3808). The survey employed a two-stage stratified sampling design that yielded a nationally representative sample at the household level. Four essential maternal healthcare services outcomes were defined: adequate (at least four visits) antenatal care by a skilled provider, lab-based test services (blood, urine and ultrasound), births with a skilled birth attendant and postnatal care by a skilled provider.Results Overall, 18.6% of women received all four maternal healthcare services. Maternal healthcare utilisation showed significant inequalities favouring wealthier and more empowered women. Regression model suggests that women who were classified in the highest quintile for empowerment index (adjusted OR (aOR)=2.17, 95% CI=1.41 to 3.33), women in the two highest quintiles for wealth index (richer: aOR=2.37, 95% CI=1.41 to 3.98; richest: aOR=2.60, 95% CI=1.41 to 4.79) and women residing in urban area (aOR=1.35, 95% CI=0.99 to 1.83) were significantly associated with the utilisation of all four healthcare services. Other factors like exposure to media (television/radio/newspaper), husband’s educational status, distance to the nearest health facility and province/region of residence also determined maternal healthcare services utilisation.Conclusion Our findings highlight the need for targeted interventions such as improving women’s education, healthcare infrastructure and distance barriers and promoting gender equality to ensure greater service utilisation. These findings could help advance further development and implementation of Mozambique’s national strategies, and development assistance, for community-based primary healthcare and women-centred care as they provide the latest evidence on this topic. |
| format | Article |
| id | doaj-art-e6481f72356f4104ba0120905d0dc272 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-e6481f72356f4104ba0120905d0dc2722025-08-20T03:48:18ZengBMJ Publishing GroupBMJ Global Health2059-79082025-05-0110510.1136/bmjgh-2024-018121Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023Sergio Chicumbe0Nazeem Muhajarine1Fernanda Andre2Md Sabbir Ahmed3Nahin Shakurun4Health System and Policy Program, Instituto Nacional de Saúde, Maputo, Maputo, MozambiqueCommunity Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaCommunity Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaCommunity Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaCommunity Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaBackground Mozambique has one of the highest maternal mortality rates in sub-Saharan Africa. While some progress has been made, further efforts are required to ensure that women in Mozambique have access to high-quality healthcare. A key strategy for reducing maternal and child mortality is to promote adequate access to and utilisation of maternal healthcare services.Methods We used the population-based, nationwide, cross-sectional Mozambique Demographic and Health Survey 2022–2023 data (n=3808). The survey employed a two-stage stratified sampling design that yielded a nationally representative sample at the household level. Four essential maternal healthcare services outcomes were defined: adequate (at least four visits) antenatal care by a skilled provider, lab-based test services (blood, urine and ultrasound), births with a skilled birth attendant and postnatal care by a skilled provider.Results Overall, 18.6% of women received all four maternal healthcare services. Maternal healthcare utilisation showed significant inequalities favouring wealthier and more empowered women. Regression model suggests that women who were classified in the highest quintile for empowerment index (adjusted OR (aOR)=2.17, 95% CI=1.41 to 3.33), women in the two highest quintiles for wealth index (richer: aOR=2.37, 95% CI=1.41 to 3.98; richest: aOR=2.60, 95% CI=1.41 to 4.79) and women residing in urban area (aOR=1.35, 95% CI=0.99 to 1.83) were significantly associated with the utilisation of all four healthcare services. Other factors like exposure to media (television/radio/newspaper), husband’s educational status, distance to the nearest health facility and province/region of residence also determined maternal healthcare services utilisation.Conclusion Our findings highlight the need for targeted interventions such as improving women’s education, healthcare infrastructure and distance barriers and promoting gender equality to ensure greater service utilisation. These findings could help advance further development and implementation of Mozambique’s national strategies, and development assistance, for community-based primary healthcare and women-centred care as they provide the latest evidence on this topic.https://gh.bmj.com/content/10/5/e018121.full |
| spellingShingle | Sergio Chicumbe Nazeem Muhajarine Fernanda Andre Md Sabbir Ahmed Nahin Shakurun Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 BMJ Global Health |
| title | Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 |
| title_full | Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 |
| title_fullStr | Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 |
| title_full_unstemmed | Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 |
| title_short | Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022−2023 |
| title_sort | inequalities and factors associated with maternal healthcare services utilisation in mozambique evidence from the demographic and health survey 2022 2023 |
| url | https://gh.bmj.com/content/10/5/e018121.full |
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