Trends and inequity in maternal health care use: Evidence from Sub-Saharan Africa and Southern Asia

Each year, more than half a million women in the world die during pregnancy, childbirth or the six weeks after delivery. Sub-Saharan African and South Asia account for over 85 percent of these maternal deaths. Although many countries are committed to achieving Millennium Development Goal 5 (MDG5): three-quarter reduction in the maternal mortality ratio between 1990 and 2015 and achieving universal access to reproductive health by 2015, progress has been very limited in these two regions. Maternal mortality remains high and with great disparity between the rich and the poor and use of maternal health care services remains low.

This study analyzes the trend and inequity by wealth in two key indicators used to monitor the progress of achieving MDG 5: antenatal care and skilled birth attendance in Sub-Saharan Africa and South Asia. The study uses Demographic and Health Surveys data from the 1990s to date for 26 Sub-Saharan African countries and 4 South Asian countries, with each country having surveys from at least two time-points. Levels and trends of antenatal care and skilled birth attendance in these countries are examined along with the inequity of use by household wealth quintiles. Multivariate regressions assess the adjusted effects of household wealth on seeking these maternal health services.

This multi-country trend and inequity analysis on maternal health care will have important policy implications. The findings could provide key inputs for identifying priorities and policies in achieving MDGs.