Predictors of Utilisation of Skilled Maternal Healthcare in Lilongwe District, Malawi

Document Type : Original Article


1 School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi

2 Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi

3 Department of Psychology, Maynooth University, Maynooth, Ireland

4 Assisting Living and Learning (ALL) Institute, Maynooth University, Maynooth, Ireland

5 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland

6 Centre for Rehabilitation Studies, Stellenbosch University, Cape Town, South Africa

7 Olomouc University Social Health Institute, Palacký University, Olomouc, Czech Republic


Despite numerous efforts to improve maternal and child health in Malawi, maternal and newborn mortality rates remain very high, with the country having one of the highest maternal mortality ratios globally. The aim of this study was to identify which individual factors best predict utilisation of skilled maternal healthcare in a sample of women residing in Lilongwe district of Malawi. Identifying which of these factors play a significant role in determining utilisation of skilled maternal healthcare is required to inform policies and programming in the interest of achieving increased utilisation of skilled maternal healthcare in Malawi.
This study used secondary data from the Woman’s Questionnaire of the 2010 Malawi Demographic and Health Survey (MDHS). Data was analysed from 1126 women aged between 15 and 49 living in Lilongwe. Multivariate logistic regression was conducted to determine significant predictors of maternal healthcare utilisation.
Women’s residence (P = .006), education (P = .004), and wealth (P = .018) were significant predictors of utilisation of maternal healthcare provided by a skilled attendant. Urban women were less likely (odds ratio [OR] = 0.47, P = .006, 95% CI = 0.28–0.81) to utilise a continuum of maternal healthcare from a skilled health attendant compared to rural women. Similarly, women with less education (OR = 0.32, P = .001, 95% CI = 0.16–0.64), and poor women (OR = 0.50, P = .04, 95% CI = 0.26–0.97) were less likely to use a continuum of maternal healthcare from a skilled health attendant.
Policies and programmes should aim to increase utilisation of skilled maternal healthcare for women with less education and low-income status. Specifically, emphasis should be placed on promoting education and economic empowerment initiatives, and creating awareness about use of maternal healthcare services among girls, women and their respective communities.


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Volume 8, Issue 12
December 2019
Pages 700-710
  • Receive Date: 13 September 2018
  • Revise Date: 31 July 2019
  • Accept Date: 03 August 2019
  • First Publish Date: 01 December 2019