Abstract
Background: Every day, globally approximately a thousand women and girls needlessly die as a result of complications during pregnancy, childbirth or the 6 weeks following delivery. The majority of maternal deaths are avoidable and could be prevented with proven interventions to prevent or manage complications during pregnancy and child birth. The aim of this study was to examine factors associated with underutilization of maternal health services in Sudan.
Methods: Data was obtained from the Sudan Household Health Survey 2010(SHHS). The SHHS collected data from 5730 women, aged 15-49 years and who were pregnant in the last 2 years preceding the survey. The selection of the respondents was through a multi-stage cluster sampling technique. Interviews were conducted with respondents to collect data about their demographic characteristics, reproductive history, pregnancy and child delivery. Univariate analysis and logistic regression were used to analyze the data.
Results: The factors associated with receiving antenatal care were, higher educational level (odds ratio (OR) = 3.428, 95 % CI 2.473-4.751 - p value 0.001), higher household wealth (OR 1.656, 95 % CI: 1.484-1.855 - p value 0.001) and low parity (OR = 1.214, 95 % CI: 1.035-1.423 -p value 0.017). The factors associated with institutional delivery were higher educational level (OR = 1.929, 95 % CI: 1.380-2.697 - p value 0.001), high household wealth (OR = 2.293, 95 % CI: 1.988-2.644 p value 0.001), urban residence (OR = 1.364, 95 % CI: 1.081-1.721 p value 0.009), low parity (OR = 2.222, 95 % CI: 1/786-2.765 p value 0.001), receiving ANC (OR = 3.342, 95 % CI: 2.306-4.844 p value 0.001) and complications during pregnancy (OR = 1.606, 95 % CI: 1.319-1.957 p value 0.001).
Conclusions: The factors associated with both antenatal care use and institutional delivery are similar and interventions to target these include expanding female education and improving coverage and affordability of health services.