MJM, Vol 70 Supplement 1 September 2015
Determinants of utilisation of maternal health care
services: a community based study in Sarawak
*Community Medicine and Public Health Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak
Introduction: The improvement of quality in maternal health care services is an effective strategy for maternal mortality reduction to achieve the Millennium Development Goal 5. Utilisation pattern of the maternal health care services and patient satisfaction indirectly measures the quality of services received. This study aimed to assess and identify the determinants for the utilisation of Maternal and Child Health (MCH) clinics and maternal health care services in Sarawak.
Methods: A cross-sectional study was conducted among the reproductive women of age 18 years and above, irrespective of ethnic groups all over Sarawak. All mothers having a child aged 3 years and below were included in this study. A total of 1236 participants were interviewed using a validated interviewer administered questionnaire. Analysis was done by IBM SPSS version 22.0 software programme. A p-value less than 0.05 was considered as statistically significant.
Results: A Maternal Care Receptivity Index (MCR) was developed based on the pattern of utilisation of antenatal, delivery and postnatal care. The median MCR index was 19 ranging from 0 to 23. The MCR was further categorised based on quartiles into excellent (39.6%) followed by good (34.1%), poor (14.8%) and lastly very poor receptivity (11.4%). Finally, multinomial logistic regression analysis revealed that the maternal care receptivity was associated by ethnicity, religion, level of education and family size (p<0.001).
Conclusion: Overall, the utilisation of maternal health services in Sarawak was high. Socio-demographic factors associated with the utilisation of maternal health services were ethnicity, level of education, religion, family size and satisfaction of delivery care services. Including main dialect used as communication tools, health education methods, considering culturally and religion-bound practices, respecting patients’ right for informed decision and consent during management and treatment may improve utilisation of maternal health care services in Sarawak.
Keywords: Antenatal care, Delivery care, Post-natal care, Maternal Receptivity Index, Sarawak.