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

Muhammad Aslam
Muhammad Aslam
, 
Maryam Sadiq
Maryam Sadiq
 and 
Tahir Mehmood
Tahir Mehmood
   | Jul 13, 2020
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Article Category: Original article
Published Online: Jul 13, 2020
Page range: 3 - 7
DOI: https://doi.org/10.1515/abm-2020-0002
Keywords
© 2020 Muhammad Aslam et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Frequency distribution of maternal care visits in Pakistan.
Frequency distribution of maternal care visits in Pakistan.

Figure 2

The modeling accuracy of count regression models over the data of maternal health care services utilization.
The modeling accuracy of count regression models over the data of maternal health care services utilization.

Characteristics of the study sample (N = 16,314) and significance of maternal care visits between subgroups

Predisposing characteristicsN (%)Median (P25–P75)P
Province*
Punjab (Pakistan)10,278 (63)3 (2–6)<0.01
Sindh (Pakistan)6,036 (37)2 (1–5)
Age*
≤ 20 years1,773 (10.9)3 (1–5)<0.01
> 20 years14,541 (89.1)3 (1–5)
Education level*
Illterate8,499 (52.1)2 (0–4)<0.01
Literate7,815 (47.9)4 (3–7)
Area*
Urban5,813 (35.6)4 (2–7)<0.01
Rural10,501 (64.4)2 (1–4)
Husband's age*
≤ 30 years6,760 (41.4)3 (1–5)<0.32
> 30 years9,554 (58.6)3 (1–6)
Domestic violence*
Yes8,667 (46.9)2 (1–4)<0.01
No7,647 (53.1)4 (2–7)
Income level†
Low7,772 (47.6)2 (0–3)<0.01
Middle3,539 (21.7)3 (2–5)
High5,003 (30.7)5 (3–8)
Access to media*
Yes9,934 (60.9)2 (0–4)<0.01
No6,380 (39.1)4 (2–6)
AIDS awareness*
Yes5,497 (33.7)5 (3–8)<0.01
No10,817 (66.3)2 (1–4)
Experience of a child's death*
Yes3,591 (2.0)2 (1–5)<0.01
No12,723 (78)3 (1–6)
Desire for pregnancy*
Yes14,345 (87.9)3 (1–5)<0.01
No1,969 (12.1)3 (1–5)
Parity*
Primipara3,583 (22)4 (2–7)<0.01
Multipara12,731 (78)3 (1–5)
Birth order*
≤ 412,185 (74.7)3 (2–6)<0.01
> 44,129 (25.3)2 (0–4)

Parameter estimates and 95% confidence interval (CI) estimates for ZINB model on maternal care utilization

CoefficientsZero-inflated regressionCount regression
Intercept0.12 (0.07–0.18)3.85 (3.59–4.13)
Province (Punjab)RefRef
Sindh0.95 (0.83–1.09)1.02 (0.99–1.05)
Age (≤ 20 years)RefRef
> 20 years1.13 (0.87–1.48)1.13 (1.08–1.18)*
Education level (Illiterate)RefRef
Literate0.43 (0.35–0.54) *1.15 (1.12–1.19) *
Area (Urban)RefRef
Rural0.89 (0.75–1.06)0.94 (0.92–0.97) *
Domestic Violence (No)RefRef
Yes1.06 (0.92–1.22)0.91 (0.89–0.93) *
Income level (Low)RefRef
Middle0.53 (0.43–0.65) *1.25 (1.20–1.29) *
High0.31 (0.23–0.42) *1.56 (1.50–1.62) *
Access to media (No)RefRef
Yes0.52 (0.45–0.60) *1.07 (1.04–1.10) *
AIDS Awareness (Yes)RefRef
No1.75 (1.36–2.24) *0.86 (0.83–0.88) *
Experience of a child's death (Yes)RefRef
No1.13 (0.97–1.32)0.90 (0.87–0.93) *
Desire for pregnancy (Yes)RefRef
No1.24 (1.03–1.49) *1.03 (0.99–1.07)
Parity (Primipara)RefRef
Multipara1.59 (1.28–1.99) *0.85 (0.83–0.88) *
Birth order (≤4)RefRef
>41.41 (1.21–1.64) *0.90 (0.87–0.93) *
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