Effects of Social and Demographic Factors on Trends in Use of Maternal Health Care: A Comparison of Guatemala and Honduras

Cynthia Stanton, Johns Hopkins University

Honduras and Guatemala are among very few developing countries with recent, well documented declines in the maternal mortality ratio. Explanations for these declines and recommendations for future programming rest squarely within the realm of supply-side, medical interventions regarding health service use. Negligible consideration is given to underlying social and demographic factors known to affect antenatal and delivery care use in the developing world. This paper presents the effects of social and demographic factors on the trends in antenatal and delivery care use in each country during the period of time in which maternal mortality has declined. Community level variables reflecting access to maternal health care services and ethnic composition are also explored. To identify unmeasured differences between Guatemala and Honduras, the independent effect of country residence, controlling for significant social, demographic and community level variables are presented. Multivariate logistic regression and Multilevel logistic regression methods are used.