Sociodemographic inequalities in utilizing maternal healthcare services in Cambodia

Abstract Background Cambodia is a Southeast Asian country and has one the highest rates of maternal and child mortality with inadequate use of maternal healthcare services in the region. The present study aimed to analyse the progress made in terms of using maternal healthcare services since 2000.Methods Two rounds of Demographic and Health Surveys (DHS 2000 and DHS 2014) were used in the study. Sample population consisted 11,961 women aged between 15-49 years. The outcome measures were: Timing of first ANC attendance, adequacy of ANC attendance, place of delivery and postnatal checkup. WHO guidelines were used to set the cut-off/define these measures.Results Findings indicated that the overall prevalence of making the first ANC visit in the first trimester was 64.19% [95%CI=62.22,66.11], and that of having at least four ANC visits was 43.80% [95%CI=41.89,45.73]. Prevalence of health facility delivery was 48.76% [46.62,50.90] and that of postnatal checkup was 71.14% [95%CI=69.21,73.01]. Between 2000 and 2014, the percentage of timely and adequate use of ANC increased by respectively 61.8% and 65.3%, while that of health facility delivery and postnatal care increased by respectively 74.5% and 43.9%. Important demographic, socioeconomic and geographic disparities were observed in the utilization of ANC, health facility delivery and postnatal care services. Urban residency, having better educational status, white collar job, access to electronic media showed positive association, whereas higher parity (having >2 children) and unwanted pregnancy showed negative association with the use of maternal healthcare services. Having at least four ANC visits was associated with significantly increased higher odds of using health facility delivery and postnatal care.Conclusion There has a been a remarkable increase in the prevalence of women who are using the maternal healthcare services since 2000. Although the data are cross-sectional that precludes assuming any causal relationship, the current findings provide important insights regarding the pattern of sociodemographic inequalities in the use of maternal healthcare services in Cambodia.