Population Level Burden and Inequities in Maternal Health in Zambia
Inequities in access to and utilisation of maternal and child health services pose significant challenges to overall health improvement. Despite the preventable nature of most maternal and child deaths, these challenges persist - leading to poor maternal and child health outcomes. Compared to several high-income countries that have successfully attained their Sustainable Development Goal targets, sub-Saharan Africa and Zambia, in particular, have experienced slower progress. Maternal health care utilisation has been shown to be a cost-effective measure in managing maternal health. However, research on the continuum of maternal health care utilisation and outcomes, especially within the Zambian context, remains limited. In a patriarchal country like Zambia, understanding the influence of gender, household and socioeconomic factors is crucial for addressing these inequities and improving maternal and child health outcomes. This study focuses on highlighting the population-level burden of morbidity among reproductive-age women and investigating the underlying socioeconomic and household factors driving inequities in continuum of maternal health care utilisation. By analysing data from the latest Zambia Demographic and Health Survey and conducting in-depth participant interviews, a contextual approach was employed to examine selected reproductive-age morbidity and maternal health care utilisation outcomes. The study reveals a high burden of reproductive-age morbidity among women, with inequities playing a significant role. Persistent maternal health disparities are influenced by gender and household socioeconomic factors, resulting in varying outcomes. Gender inequities affect the continuum of maternal health care utilisation, while household composition and structure have diverse effects, and should not be conflated when analysing maternal health care utilisation. To achieve Zambia Vision 2030 and Sustainable Development Goal 3, policy interventions should prioritise addressing these inequities and implementing equity-enhancing measures, thus working towards improved maternal and child health outcomes in Zambia.
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