Socioeconomic position as a determinant of maternal healthcare utilization: a population-based study in Namibia.

BACKGROUND Improving maternal health is one of the eight Millennium Development Goals (MDGs) aimed at improving maternal healthcare and reducing maternal mortality. The utilization of maternal health services is influenced by several factors that need to be better understood. The objective of this study was to estimate the role of socio-economic position as a determinant of the utilization of maternal health care in Namibia. METHODS Data were collected from the Namibia Demographic and Health Survey in 2006-2007, based on survey responses from 9,804 female respondents aged 15-49 years. Multivariate logistic regression analysis was performed accounting for socio-economic factors associated with the use of maternal health care services. RESULTS The results from both bivariate and multivariate analyses confirmed the importance of education, wealth index, place of residence and marital status in explaining the utilization of maternal health care services. Wealth index was the only consistently significant predictor of all indicators of maternal health services; with other factors being significantly associated with one or more of the indicators. Women's age and occupation showed inconclusive results in relation to access to maternal health care services. CONCLUSIONS Several socio-economic factors significantly influence the three indicators of maternal health services utilization. Effective interventions need to take these factors into consideration and to explore means that increase maternal health service utilization especially among lowly educated and poor women in rural areas.