Peer-reviewed article
Patterns of maternal and child health services utilization and associated socioeconomic disparities in sub-Saharan Africa
Claire Najjuuko, Ziqi Xu, Samuel Kizito, Chenyang Lu, Fred M. Ssewamala ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined patterns of maternal and child health service use among families of children who died before age five across 31 sub-Saharan African countries. The researchers found that service utilization fell into three distinct patterns, from lowest to highest use. Socioeconomic factors—particularly maternal education, employment, wealth, and urban residence—strongly predicted which families used fewer services. The research highlights significant health inequalities linked to socioeconomic status in the region.
Key points
- Among 9,307 under-five mortality cases across 31 sub-Saharan African countries, maternal and child health service utilization fell into three distinct patterns: lowest, medium, and highest
- Higher maternal education, employment, urban residence, and wealth were associated with lower odds of being in the lowest utilization group
- Socioeconomic status strongly predicts subgroup membership and service utilization patterns
- Inequality indices revealed disparities by education, wealth, residence, and employment
- Targeted strategies are needed to improve access and uptake of essential health services among socioeconomically disadvantaged groups
Limitations
This study examined service utilization patterns among families who experienced under-five deaths and cannot explain causation or identify which specific services would have prevented those deaths. The cross-national analysis may mask country-specific context and barriers to service access.
Abstract
Under-five mortality remains a global health issue, especially in sub-Saharan Africa, where preventable conditions largely drive the high mortality rates. Understanding the heterogeneity in utilization of reproductive, maternal, newborn, and child health services is crucial for reducing under-five mortality. Here we show that among 9307 under-five mortality cases across 31 sub-Saharan African countries (2014–2024), maternal and child health service utilization falls into three distinct patterns—lowest, medium, and highest. Socioeconomic status strongly predicts subgroup membership: higher maternal education, employment, urban residence, and wealth are associated with lower odds of being in the lowest utilization group. Inequality indices further reveal disparities by education, wealth, residence, and employment. Our findings show a strong link between socioeconomic status and maternal and child health services utilization. To address under-five mortality in sub-Saharan Africa, targeted strategies are needed to improve access and uptake of essential health services among socioeconomically disadvantaged groups. Reproductive, maternal, newborn, and child health (RMNCH) services are seen as important in addressing under-five mortality. This study finds that socioeconomic status predicts utilization of these services in sub-Saharan Africa. Uptake of essential services among low socioeconomic status groups must be improved.