Determinants of the utilization of maternal and child health services in Jordan

Abstract

The utilization of antenatal, delivery and postnatal services by a random sample of married women in Jordan during their most recent pregnancy resulting in a live birth is analysed. Marked variations are shown in the use of these services and of preventive infant care for women living in urban and rural areas. Women with increasing levels of formal education and those living near services were significantly more likely to use services. If effective coverage of these services is to be achieved then it is suggested that greater emphasis should be placed upon outreach and realistic social marketing.

PIP: A survey of 1765 married women in Jordan with a recent live birth revealed wide variations in the utilization of antenatal, delivery, and postnatal services. The respondents were representative of the total population of Jordan, with 46% living in the 3 main cities, 20% in the other urban localities, and 34% in smaller settlements. 50% of respondents received no antenatal care; this rate was highest (69%) among rural women and lowest (38%) among those from the urban centers. 48% delivered in a hospital, with a range from 38% among rural women to 60% in urban centers. 43% of those living in towns compared with only 35% of those in rural areas made use of postnatal services. 72% of respondents in rural areas versus 7% of those in the 3 main cities and 10% of women in other urban areas lived further than 5 km from a maternal-child health clinic. 53% indicated they had not received any health education dealing with pregnancy and delivery. The use of antenatal services was significantly associated with the following individual and health service access variables: level of female education, duration of marriage, increasing female age, parity 4-6, and low distance to health facility. Time and cost involved in travelling to services were significantly associated with nonuse. These findings suggest a need for more effective maternal-child health program coverage and outreach.