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PreprintCited by 27Global Maternal and Child HealthReproductive Health and ContraceptionMaternal and fetal healthcare

The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index.

The Influence of Contextual Factors on Maternal Healthcare Utilization in sub-Saharan Africa: A Scoping Review of Multilevel Models

Open access
Simona, Simona, Lumamba, Casildah, Moyo, Felicitas, Ng’andu, Emily, Phiri, Million·2022·medRxiv
DOI 10.1101/2022.03.15.22272437
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Abstract

Introduction: Sub-Saharan Africa still bears the heaviest burden of maternal mortality among the regions of the world, with an estimated 201,000 (66%) women dying annually due to pregnancy and childbirth related complications. Utilisation of maternal healthcare services including antenatal care, skilled delivery and postnatal care contribute to a reduction of maternal and child mortality and morbidity. Factors influencing use of maternal healthcare occur at both the individual and contextual levels. The objective of this study was to systematically examine the evidence regarding the influence of contextual factors on uptake of maternal health care in sub-Saharan Africa. Materials and Methods: The process of scoping review involved searching several electronic databases, identifying articles corresponding to the inclusion criteria and selecting them for extraction and analysis. Peer reviewed multilevel studies on maternal healthcare utilisation in sub-Saharan Africa published between 2007 and 2019 were selected. Two reviewers independently evaluated each study for inclusion and conflicts were resolved by consensus. Results: We synthesised 34 studies that met the criteria of inclusion out of a total of 1,654 initial records. Most of the studies were single-country, cross-sectional in nature and involved two-level multilevel logistic regression models. The findings confirm the important role played by contextual factors in determining use of available maternal health care services in sub-Saharan Africa. The level of educational status, poverty, media exposure, autonomy, empowerment and access to health facilities within communities are some of the major drivers of use of maternal health services. Conclusions: This review highlights the potential of addressing high-level factors in bolstering maternal health care utilisation in sub-Saharan Africa. Societies that prioritise the betterment of social conditions in communities and deal with the problematic gender norms will have a good chance of improving maternal health care utilisation and reducing maternal and child mortality. Better multilevel explanatory mechanisms that incorporates social theories are recommended in understanding use of maternal health care services in sub-Saharan Africa.

Overview

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Crossref · 10.1101/2022.03.15.22272437

Cites

65 of 65 references verified0 citation errors · 0 not checkable

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Citations

Cites

Research works printed but not linked: 3

  1. 2008, Understanding barriers to maternal child health services utilization in northern Ghana, Journal of Social Development in Africa, 23, 127
  2. 10.1136/jech.56.8.588 · DOI
  3. Simona SJ . Structural violence and maternal healthcare utilisation in sub-Saharan Africa: A Bayesian multilevel analysis. PhD thesis, University of Glasgow. 2020. Available from: https://theses.gla.ac.uk/80281/1/2020SimonaPhD.pdf

Cited by

See all 27

Metadata

Authors
Simona, S., Lumamba, C., Moyo, F., Ng’andu, E., & Phiri, M.
Affiliations
  • University of Zambia (ZM)
  • University of the Witwatersrand (ZA)
Corresponding author
Simona, Simona
ORCID
Venue
medRxiv
Publisher
openRxiv
Published
2022-03-18
DOI
10.1101/2022.03.15.22272437
OpenAlex
W4220737875
Cited by
27
References
65
Citations by year
2026: 2 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 4
Type
posted content
Language
en
Open access
Licence
cc-by
Locations
medRxiv (acceptedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Keywords
maternal health service utilization, contextual factors, sub-Saharan Africa, prenatal care, skilled delivery, postpartum care, maternal mortality, maternal and child mortality, educational attainment, poverty, media exposure, women's autonomy, women's empowerment, access to health facilities, gender norms, social determinants of health

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