BackgroundMaternal and child healthcare services are very important for the health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. Studying these services is necessary in developing countries where infrastructure (which is meant to deal with these health services) is minimal or lacking. The objective of the study is to examine the factors that influence the use of maternal healthcare services and childhood immunization in Swaziland.MethodsOur study used secondary data from the Swaziland Demographic and Health Survey 2006–07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. We ran three different types of analyses: univariate, bivariate and multivariate. For the multivariate analysis, a logistic regression was run to investigate the relationship between the dependent and independent variables.FindingsThe study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%) and a low rate of postnatal care use (20.5%). The uptake of childhood immunization is also high in the country, averaging more than 80.0%. Certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth quintile, and residence. The findings also revealed that these factors affect the use of maternal and child health services differently.ConclusionIt is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. In addition, interventions should focus on: (a) age differentials in use of maternal and child health services, (b) women with higher parities, (c) women in rural areas, and (d) women from the poor quintile. We recommend that possible future studies could use the qualitative approach to study issues associated with the low use of postnatal services.

BackgroundThe main aim of the study is to examine whether women in Mdantsane are accessing and using maternal health care services. Accessibility of maternal health care facilities is important in ensuring that lives are saved through the provision and use of essential maternal services. Therefore, access to these health care services directly translates to use – that is, if women cannot access life-saving maternal health care services, then use of such services will be limited.FindingsThe study makes use of mixed methods to explore the main factors associated with access to and use of maternal health care services in Mdantsane. For the quantitative approach, we collected data using a structured questionnaire. A sample of 267 participants was selected from health facilities within the Mdantsane area. We analyzed this data using bivariate and multivariate models. For the qualitative approach, we collected data from health care professionals (including nurses, doctors, and maternal health specialists) using one-on-one interviews. The study found that women who were aged 35–39, were not married, had secondary education, were government employees, and who had to travel less than 20 km to get to hospital were more likely to access maternal health services. The qualitative analysis provided the insights of health care professionals regarding the determinants of maternal health care use. Staff shortages, financial problems, and lack of knowledge about maternal health care services as well as about the importance of these services were among the major themes of the qualitative analysis.ConclusionA number of strategies could play a big role in campaigning for better access to and use of maternal health services, especially in rural areas. These strategies could include (a) the inclusion of the media in terms of broadcasting information relating to maternal health services and the importance of such services, (b) educational programs aimed at enhancing the literacy skills of women (especially in rural areas), (c) implementing better policies that are aimed at shaping the livelihoods of women, and (d) implementing better delivery of maternal health care services in rural settings.

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Aim is to find out the disparities in cesarean sections among institutional deliveries across segments of the society in the study area. The National Family Health Survey data 2005-06 were used. There were 14,808 women who were found to be relevant for this study. Bivariate results show that cesarean section is highest among women older than 40 years, having the highest level of education, holding skilled jobs, from the highest social hierarchy, who delivered in private health institutions, experienced cesarean section in previous delivery, and had pregnancy complications. Performance of cesarean section may be necessary for safety of both mother and infant.