Familial determinants of the use of maternal health services in rural Africa: A multi-countries analysis

Vissého D. Adjiwanou, Université de Montréal

Given a persisting high fertility level and non-utilization of health services in many African countries, the burden of maternal mortality and morbidity related to pregnancy will continue to jeopardize the achievement of the Millennium Development Goals (MDGs). This analysis used data from Demographic and Health Surveys in Kenya, Tanzania, Uganda and Ghana. With a method that attempts to account for endogeneity, we estimate simultaneously four antenatal visits, the quality of antenatal care and skilled birth attendance on family characteristics of women and on their spouse’s characteristics. Our results show the absence of a direct effect of prenatal care use on the subsequent use of skilled birth attendants in Kenya, in Tanzania and in Uganda. However, the quality of service received during the antenatal visit is positively associated with skilled birth attendance in these countries. The education of the spouse is significant in predicting skilled birth attendance in all countries except Kenya, where employment status has an effect.