Individual-and Community-Level Determinants of Maternal Healthcare Utilization in Afghanistan

To increase the utilization of maternal healthcare services, the factors that affect must first be identified. However, national-level studies on this topic in the country are lacking. Therefore, this chapter aims to identify and examine the factors affecting maternal healthcare utilization in Afghanistan. This chapter uses data from the first Demographic and Health Survey conducted in Afghanistan in 2015 to examine the factors associated with the utilization of maternal healthcare services among ever-married women (aged 15–49) who have had at least one birth during the 5 years preceding the survey. Multilevel binary logistic regression analyses were carried out to understand the net effect of predictor variables on the utilization of maternity care. The results show that the utilization of maternal health services is considerably low in Afghanistan. Only about 18%, 48%, and 33% Afghan mothers had availed themselves of antenatal care (ANC), safe delivery, and postnatal care (PNC) services, respectively. Findings have indicated a considerable amount of variation in the use of maternity care depending on education, wealth, ethnicity, parity, and place of residence. Maternal care in Afghanistan is associated with a woman and her partner’s education, ethnicity, wealth, parity, exposure to mass media, and place of residence. The chapter finds a strong association between the utilization of antenatal care and both safe delivery and postnatal care. Exposure to mass media and mothers’ participation in health expenditure decision-making are positively associated with maternal care utilization in Afghanistan. These results suggest the need to adopt a targeted approach to reduce differentials in the utilization of maternal care in Afghanistan. In the short term, the government should focus on promoting antenatal care and the use of mass media. In the long term, the government should promote girl’s education and reduce wealth inequalities.