Utilization of Maternal Health Care in Yemen

A recent UN Report ranked Yemen 154 on its Human Development Index with a per capita income of less than $4000. Wide differentials are observed between rural and urban areas regarding utilization of maternal care services in Yemen. The recommended minimum of four antenatal care follow-up visits were received by 47 percent of births to mothers living in urban areas, but for only 16 percent of births to mothers living in rural areas. Similarly, 49 percent of deliveries in urban areas, and only 23 percent of deliveries in rural areas, took place in health care facilities. These measures indicate that the utilization of various maternal care services are not encouraging, particularly in the rural areas. In the present analysis we addressed the limitations that exist in the literature and used the theoretical framework developed by Andersen and Newman (1973). This approach incorporates both individual and program characteristics in addressing the utilization of maternal care services in rural areas of Yemen. To capture the complexity of the various aspects of maternal care utilization we constructed a composite index based on the various components of the maternal care services. The preliminary analysis indicates that among the various socioeconomic and demographic variables considered, variables such as birth order, education of woman, household standard of living index and women’s exposure to mass media have larger variations in the utilization of maternal care services, even after controlling for other predictor variables. Similarly, among various community level and program variables considered, a health worker visit during pregnancy and the distance to a government health facility have strong and statistically significant influence on the utilization of maternal care services.