What explains the rural-urban inequalities in maternal health services utilization in Tanzania? a Fairlie decomposition analysis

Background: Maternal mortality remains a public health issue in developing countries, with rural areas having higher rates compared to urban areas. Since effective utilization of maternal health services has the potential to reduce maternal mortality, this study measures the factors contributing to the existing rural-urban differences in the utilization of maternal health services in Tanzania Methods: We used Tanzania Demographic and Health Survey 2015/2016 data. Multi-stage stratified sampling was used to select study participants and we estimated a Fairlie decomposition to understand factors that contribute to inequality in maternal health services utilization between rural and urban areas in Tanzania using Stata 17. Results: The study findings revealed a considerably wide rural-urban disparity in the utilization of maternal health services. As the findings indicated, household wealth status is the major factor for that disparity. Other factors are women’s exposure to the media, women’s working status, and distance from the homesteads to the health facilities. Conclusion: Therefore, any policy geared toward bridging the gap between rural and urban areas in the utilization of maternal health services should focus on empowering women in terms of household economic status, media exposure, and employment.