Spatial Clustering of Maternal Health Services Utilization and Its Associated Factors in Tanzania: Evidence From Tanzania Demographic Health Survey 2015-16

Abstract Background: Maternal healthcare services are major component for the health outcomes of the pregnant woman in making sure the deaths of mother and child are prohibited. This study aimed to examine the spatial clustering of maternal health care services utilization and the associated factors in Tanzania. Methods: The study utilized the Tanzania Demographic Health Survey and Malaria Indicators Survey 2015-16 data. The study carried out to 7,013 women aged between 15 and 49 years who had a live birth in the five years preceding the survey. Spatial analysis was done using the Bernoulli model through Kullodorff scan statistics, and multiple logistic regression analysis was employed to identify the predictors of maternal health services utilization Results : Spatial variations of antenatal care visit and delivery care across the regions was observed. Spatial scan statistic identified high utilization performing cluster for antenatal care centroid in Morogoro Region [RR=1.67, p<0.001] and low utilization in Kaskazini Pemba Region [RR=0.38, p<0.001]. For delivery care utilization, high utilization was observed in Mtwara Region [RR=1.83, p<0.001] and low utilization in Kigoma Region [RR=0.41, P<0.001]. Utilization of antenatal and delivery care services was higher among women from the richest households, with fewer children, living in urban areas and had acquired a higher education level. Conclusion: Results permit more insight into the differences in maternal health service utilization in relation to demographic characteristics in the country. In addition, findings highlight areas with low utilization performing clusters. Such finds are beneficial in the implementation of policy and intervention to expand maternal health care uptake in cross the regions.