Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries

Abstract

BackgroundRelative to the attention given to improving the quality of and access to maternal health services, the influence of women's socio-economic situation on maternal health care use has received scant attention. The objective of this paper is to examine the relationship between women's economic, educational and empowerment status, introduced as the 3Es, and maternal health service utilization in developing countries.Methods/Principal FindingsThe analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in relation to the three covariates of interest: economic, education and empowerment status, additionally controlling for women's age and residence. We use meta-analysis techniques to combine and summarize results from multiple countries. The 3Es are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth.Conclusions/SignificanceEfforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1), universal primary education (MDG 2), and women's empowerment (MDG 3).

Towards an understanding of the multilevel factors associated with maternal health care utilization in Uttar Pradesh, India

“…Moreover, women who are able to read or write have better chances of receiving antenatal care and higher numbers of them choose to deliver at health facilities rather than at home. These two findings are consistent with the results in the literature finding that education matters for maternal health utilization [9,31–35]. …”

Community Socioeconomic Context and Its Influence on Intermediary Determinants of Child Health: Evidence From Colombia

“…These results are consistent with findings elsewhere examining the use of maternal health facilities (Stephenson et al, 2006;Ahmed et al, 2010) and underline the importance of women's empowerment within the household, allowing them to have greater decision-making powers regarding both their own health and that of their children.…”

Drug therapy, lifestyle modification and blood pressure control in a primary care facility, south of Johannesburg, South Africa: an audit of hypertension management

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