Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis
Abstract
Maternal mortality is a critical public health issue, especially in low- and middle-income countries (LMICs). Maternal healthcare services (MHS), including antenatal care (ANC) visits, skilled birth attendants (SBA), institutional delivery (ID), and postnatal care (PNC), are crucial policy priorities to address maternal mortality and improve pregnancy outcomes. This systematic review and meta-analysis aimed to provide a comprehensive, quantitative analysis of MHS utilization among women in LMICs. We conducted a comprehensive search on PubMed, Scopus, Web of Science, CINAHL, and SocINDEX to gather relevant studies on the utilization of MHS in LMICs conducted between January 2015 and December 2024. These were then synthesized both quantitatively and qualitatively and random-effect models were employed to obtain pooled estimates. A total of 145 studies included in this review. Coverage of at least one ANC visit (ANC1), at least four ANC visits (ANC4), SBA, ID and PNC were reported in 66, 108, 42, 63, and 37 studies respectively and for these studies pooled prevalences of ANC1, ANC4, SBA, ID, and PNC were found 85.0% (95% CI 81.2–88.1%), 50.8% (95% CI 46.4–55.2%), 65.6% (95% CI 58.7–71.9%), 66.9% (95% CI 60.3–72.9%), and 48.9% (95% CI 41.7–56.2%), respectively, with high heterogeneity among the studies (I2 > 99.0%). Results obtained from the sub-group analysis revealed that the prevalence of MHS indicators was higher in the South and Southeast Asia (SSEA) region compared to…
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