Inequalities and factors associated with maternal healthcare services utilisation in Mozambique

Evidence from the Demographic and Health Survey 2022−2023

Bibliographic Data

ID21879772
AuthorsNazeem Muhajarine (0000-0001-6781-5421, Saskatchewan Health Authority), Nahin Shakurun (0009-0007-0948-1321, University of Saskatchewan), Md Sabbir Ahmed (0000-0002-7663-2181, University of Saskatchewan), Fernanda Andre (University of Saskatchewan), Sérgio Chicumbe (0000-0002-2498-9373, Instituto Nacional de Saúde)
Year2025
Volume10
Issue5
Pagese018121
Publication date2025-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-018121
PMID40412813
OpenAlexW4410711816
LanguageEN
References cited34

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

Birth attendant · Cross-sectional study · Economic growth · Empowerment · Environmental health · Health care · Health facility · Health services · Maternal health · Population · Public health · COVID-19 Impact on Reproduction · Demography · Global Maternal and Child Health · Maternal and fetal healthcare · Medicine · Nursing

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