title: Determinants of maternal health services utilization in Uganda.
abstract: BACKGROUND
  Uganda's poor maternal health indicators have resulted from weak maternal health services delivery, including access to quality family planning, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns. This paper investigated the predictors of maternal health services (MHS) utilization characterized as: desirable, moderate and undesirable.
  
  
  METHODS
  We used a sample of 1728 women of reproductive ages (15-49), who delivered a child a year prior to the 2011 UDHS survey. A multinomial logistic regression model was used to analyze the relative contribution of the various predictors of ideal maternal health services package utilization. Andersen's Behavioral Model of Health Services Utilization guided the selection of covariates in the regression model.
  
  
  RESULTS
  Women with secondary and higher education were more likely to utilize the desirable maternal health care package (RRR = 4.5; 95% CI = 1.5-14.0), compared to those who had none (reference = undesirable MHS package). Women who lived in regions outside Kampala, Uganda's capital, were less likely to utilize the desirable package of maternal health services (Eastern--RRR = 0.2, CI = 0.1-0.5; Western--RRR = 0.3, CI = 0.1-0.8; Central--RRR = 0.3, CI = 0.1-0.8; Northern--RRR = 0.4, CI = 0.2-1.0). Women from the richest households were more likely to utilize the desirable maternal health services package (RRR = 1.9; 95% CI = 1.0-3.7). Residence in rural areas, being Moslem and being married reduced a woman's chances of utilizing moderate maternal health care services.
  
  
  CONCLUSIONS
  Utilization of maternal health services varied greatly by demographic and socio-economic characteristics. Women with a secondary and higher education, and those of higher income levels, were more likely to utilize the ideal maternal health services package. Therefore, there is need to formulate policies and design maternal health services programs that target the socially marginalized women.
authors.affiliation: Makerere University, Centre for Population and Applied Statistics (CPAS), Kampala, Uganda. grutaremwa@bams.mak.ac.ug.|United Nations Economic Commission for Africa (UNECA), Addis Ababa, Ethiopia. grutaremwa@bams.mak.ac.ug.
authors.forename: Gideon
authors.initials: G
authors.lastname: Rutaremwa
authors.affiliation: Makerere University, Centre for Population and Applied Statistics (CPAS), Kampala, Uganda. swandera@gmail.com.
authors.forename: Stephen Ojiambo
authors.initials: SO
authors.lastname: Wandera
authors.affiliation: United Nations Population Fund (UNFPA), Uganda Country Office, Kampala, Uganda. jhamba@unfpa.org.
authors.forename: Tapiwa
authors.initials: T
authors.lastname: Jhamba
authors.affiliation: United Nations Population Fund (UNFPA), Uganda Country Office, Kampala, Uganda. akiror@unfpa.org.
authors.forename: Edith
authors.initials: E
authors.lastname: Akiror
authors.affiliation: Uganda Bureau of Statistics (UBOS), Ministry of Finance, Planning and Economic Development (MoFPED), Kampala, Uganda. angela.kiconcon@ubos.org.
authors.forename: Angela
authors.initials: A
authors.lastname: Kiconco
mesh_terms: D000293:Adolescent; D000328:Adult; D035841:Behavioral Research; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D014454:Uganda; D055815:Young Adult