Assessment of maternal health services utilization in Pakistan: the role of socio-demographic characteristics

Background: High-quality prenatal care has a significant positive impact on maternal and infant health as it helps timely diagnosis and treatment of pregnancy complications. Objective: To examine factors associated with the utilization of maternal health care using the optimal count regression model. Methods: A sample of 16,314 women of reproductive ages (15-49) was used. Andersen and Newman's behavioral model of health services utilization was employed for the selection of covariates. Poisson, negative binomial, zeroinflated Poisson, zero-inflated negative binomial (ZINB), Poisson hurdle, and negative binomial hurdle models were fitted and compared to identify the best model. Maternal health care utilization is found associated with maternal age and education, area of residence, domestic violence, the income level of family, access to media, knowledge about AIDS, parity, birth order, and having a child who later died. Results: ZINB model is found to be best fitted for the observed data resulting strong influence of mother's education and income level of the family on maternal health care utilization. Conclusion: Interventions to improve maternal care services utilization should address individuals and systems to reduce social and economic marginalization.