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Predictors of maternal health services uptake in West African region: a multilevel multinomial regression analysis of demographic health survey reports
Authors: Aklilu Habte, Samuel Hailegebreal and Atsedu Endale Simegn
Source: Reproductive Health, Volume 21; DOI:
Topic(s): Health care utilization
Maternal health
Country: Africa
  Multiple African Countries
Published: APR 2024
Abstract: Background Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013–2021). Methods This study was based on the appended women's (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15–49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into ‘no’, ‘partial’, or ‘adequate’ use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p?