Factors Associated with Maternal Health Services Utilization Among Lao Adolescents: A Nationwide Retrospective Cross-sectional Study

Addressing the social determinants of health that affect adolescent pregnancy is paramount to eliminating disparities and achieving health equity toward reducing the maternal mortality rate. The Lao People's Democratic Republic has a high adolescent childbearing rate, which can negatively impact maternal and child health. We conducted a retrospective cross-sectional study that used data from the pooled Lao Social Indicator Survey II of 2017 to clarify the social contextual factors associated with the utilization of adolescent antenatal care and facility deliveries. We analyzed data from 663 adolescents aged 10-19 years at delivery and extracted the factors associated with maternal healthcare utilization based on social determinants. Those factors were area and region of residence, educational status, marital status, the ethnolinguistic group of the household head, and economic strata. A multiple logistic regression analysis was performed to determine the factors associated with those factors. The results showed that social factors strongly associated with the use of antenatal care were higher educational status and higher economic strata. On the other hand, the social factors associated with facility delivery were being in an ethnic majority and having a higher economic status. Thus, it is essential to establish interventions targeting those factors, such as lower educational status, lower socioeconomic status, and being from an ethnic minority, to increase adolescents' antenatal care visits and facility deliveries. This study's results can be used to inform nurses and midwives in their efforts to eliminate socioeconomic disparities. This can be done by enhancing the provision of antenatal care consultations and facility deliveries in Lao, thus helping to achieve better health for adolescent mothers, their infants, and their families.