The Role of Information and Communication Technology in Maternal Health Care Access in Somaliland: A Multilevel Ordinal Logistic Regression Analysis of SLDHS 2020

Abstract Background Maternal health remains a critical challenge in Somaliland, where socioeconomic, geographic, and informational barriers make it hard to get care. Information and Communication Technology can make it easier for mothers to get health care by raising awareness and ensuring they get care on time. This study investigated the influence of ICT and socio-demographic factors on maternal healthcare access among women in Somaliland. Methods This cross-sectional study utilized data from 2,565 women of reproductive age (15–49 years) who participated in the 2020 Somaliland Demographic and Health Survey (SLDHS). Maternal health care access was classified as absent, moderate, or severe issue according to perceived obstacles to care. Exposure to ICT encompassed mobile phone ownership, internet usage, and the regularity of interaction with mass media (television, radio, newspapers). We used multilevel ordinal logistic regression to look at how ICT and socio-demographic factors affected access to maternal health care, taking into account clustering at the community level. We reported adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results Socioeconomic status, region, literacy, partner’s occupation, and ICT exposure had a big effect on access to maternal health care. Women in the highest wealth category were less likely to have access problems (AOR = 0.438; 95% CI: 0.24–0.80). On the other hand, women in remote areas like Sanaag were more likely to have access problems (AOR = 8.783; 95% CI: 4.84–15.94). There was a strong link between ICT exposure and better access. Women who used the internet or watched TV, listened to the radio, or read newspapers on a regular basis were much less likely to have access problems (AORs between 0.352 and 2.41). Having a cell phone by itself did not have a big effect on access. Conclusion Access to maternal health care in Somaliland is unfair and heavily affected by socioeconomic, regional, and informational factors. Exposure to ICT and mass media is very important for improving access. This shows that we need to focus on ICT-based interventions and strategies that are specific to each region. Strengthening digital health literacy and ensuring equitable information dissemination can reduce barriers and enhance maternal health outcomes.