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Abstract：
BACKGROUND: Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013-2021).
METHODS: This study was based on the appended women\'s (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15-49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into \'no\', \'partial\', or \'adequate\' use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05.
RESULTS: 66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake.
CONCLUSIONS: The uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women\'s autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes.
METHODS: This study was based on the appended women\'s (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15-49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into \'no\', \'partial\', or \'adequate\' use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05.
RESULTS: 66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake.
CONCLUSIONS: The uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women\'s autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes.
摘要：
背景：根据研究，接受三项关键的孕产妇保健服务(产前保健，熟练的送货服务,和产后护理）可以连续预防71％的全球孕产妇死亡。尽管西非地区以产妇死亡率高和无法获得产妇保健服务而闻名，缺乏深入研究孕产妇保健服务范围的研究。因此，本研究旨在使用最新的人口与健康调查(DHS)数据(2013-2021年),在单一分析模型中评估部分和充分利用卫生服务的水平和预测因素.
方法：本研究基于12个西非国家的附加妇女（IR）档案。STATA软件版本16用于分析89,504名15-49岁女性的加权样本。通过将三个关键的卫生服务组合在一起，并将其分类为\'否\'，创建了孕产妇保健服务利用的综合指数，\'部分\',或\'足够\'使用。进行了多级多变量多项逻辑回归分析，以检查每个预测因子对服务利用水平的影响。使用调整后的相对风险比（aRRR）和相应的95％置信区间报告关联程度，在p<0.05时宣布有统计学意义。
结果：66.4％（95％CI：64.9，67.7）和23.8％（95％CI：23.3，24.2）的妇女部分和充分地使用了孕产妇保健服务，分别。多哥在该地区获得适当医疗保健的妇女比例最高，56.7%，虽然尼日利亚的比例最低，在11%。产妇教育,residence,财富指数，奇偶校验，媒体曝光(广播和电视)，参加健康保险计划，对待殴打妻子的态度，和自主决策被认为是部分和充分接受孕产妇保健服务的重要预测因素。
结论：发现该地区充分的孕产妇保健服务的使用率很低。利益相关者应计划和实施增加妇女自主权的干预措施。计划规划者和医疗保健提供者应适当重视那些没有正规教育和来自低收入家庭的妇女。政府和私营部门需要合作，以改善媒体准入，并增加医疗保险计划的公众入学率。
方法：本研究基于12个西非国家的附加妇女（IR）档案。STATA软件版本16用于分析89,504名15-49岁女性的加权样本。通过将三个关键的卫生服务组合在一起，并将其分类为\'否\'，创建了孕产妇保健服务利用的综合指数，\'部分\',或\'足够\'使用。进行了多级多变量多项逻辑回归分析，以检查每个预测因子对服务利用水平的影响。使用调整后的相对风险比（aRRR）和相应的95％置信区间报告关联程度，在p<0.05时宣布有统计学意义。
结果：66.4％（95％CI：64.9，67.7）和23.8％（95％CI：23.3，24.2）的妇女部分和充分地使用了孕产妇保健服务，分别。多哥在该地区获得适当医疗保健的妇女比例最高，56.7%，虽然尼日利亚的比例最低，在11%。产妇教育,residence,财富指数，奇偶校验，媒体曝光(广播和电视)，参加健康保险计划，对待殴打妻子的态度，和自主决策被认为是部分和充分接受孕产妇保健服务的重要预测因素。
结论：发现该地区充分的孕产妇保健服务的使用率很低。利益相关者应计划和实施增加妇女自主权的干预措施。计划规划者和医疗保健提供者应适当重视那些没有正规教育和来自低收入家庭的妇女。政府和私营部门需要合作，以改善媒体准入，并增加医疗保险计划的公众入学率。
