Prioritizing the urban in provision in spite of higher utilization in the rural: the paradox of maternal healthcare services in Sub-Saharan Africa

Yemi Adewoyin, University of Nigeria, Nsukka (UNN)
Nkem Adeyemi-Adewoyin, University of Ibadan, Ibadan
Clifford O. Odimegwu, University of the Witwatersrand

Maternal health outcomes are poorest in Sub-Saharan Africa. Among others, this has been attributed to the low level of utilization of maternal healthcare services on the continent. With the urban bias in the provision of healthcare facilities and other public goods using population distribution as a corollary of need, this study hypothesizes that the low level of utilization of maternal healthcare services on the continent stems from a locational mismatch in provision and utilization. Data on place of delivery, place of residence, and other sociodemographic variables among 82,918 parous women aged 15-49 in Kenya, Namibia and Nigeria was extracted from the Demographic and Health Surveys of the three countries and analysed at univariate, bivariate and multivariate levels. Results show that more rural women (54.1%) in Kenya utilized health facilities for delivery while in Namibia and Nigeria, the proportions were almost evenly split between urban and rural areas. Relative to rural women, urban women in the three countries had lower odds of using health facilities for delivery (OR: 0.212 – 0.268, P < 0.05). The odds remained negative when other sociodemographic confounders were accounted for. Prioritizing rural healthcare in Africa portends great advantage for improving maternal health outcomes on the continent.

Keywords: Population geography, Politics and demography, Policy

See extended abstract.

  Presented in Session P23.