title: Personal and environmental predictors of the intention to use maternal healthcare services in Kalomo, Zambia.
abstract: Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The purpose of this study was to identify important factors influencing women's intention to use these services in Kalomo, Zambia. An interviewer-administered questionnaire was used to collect data from 1007 women of reproductive age (15-45 years) from 13 rural health centres with the lowest service utilization rates in the district. Questions included measures of (past) healthcare seeking behaviour, psychosocial variables (attitude, perceived social norms, perceived behavioural control), logistical barriers (e.g., distance to the clinic) and sociodemographic variables (e.g., age, income and education level). Overall, our findings showed that most respondents had high intention to use healthcare services. Intention was positively associated with attitude, personal norms, behavioural control, education and income levels. Conversely, intention was negatively related to perceived social norms, age and distance. Multivariate regression analysis showed that, together, these variables accounted for 41.8% of the variance in intention, with perceived behavioural control being the strongest predictor of intention, followed by geographical distance and perceived social norms. These findings suggest that public health programmes mitigating these important factors are likely to motivate pregnant women to use maternal healthcare services.
authors.affiliation: Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA cephas.sialubanje@maastrichtuniversity.nl.
authors.forename: Cephas
authors.initials: C
authors.lastname: Sialubanje
authors.affiliation: Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA.
authors.forename: Karlijn
authors.initials: K
authors.lastname: Massar
authors.affiliation: Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA.
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.affiliation: Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA and Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118, USA.
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D033182:Intention; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D011795:Surveys and Questionnaires; D015024:Zambia