Prevalence and factors associated with low utilization of maternal services among women attending health services in Marávia and Zumbo districts, Tete province, Mozambique

Worldwide, Maternal mortality continues to be a major problem. This study explored the prevalence and factors associated with low utilization of maternal services among women attending health services in Marávia and Zumbo districts, Tete province, Mozambique. Using a probability proportional sampling, data of 381 participants were collected using an interview-administered questionnaire. Binary and multivariate logistic regression analyses were performed. Of the 381 participants 283 (74,3%), (95% CI: 69.7–78.5) had four or more ANC visits, and 98 (25,7%) had less. More than a half of participants 211 (56,4%) initiated ANC visit after the first trimester of pregnancy, and 163 (43,6%) (95% CI: 38.6–48.6) within the first trimester, 267 (70.1%) (95% CI: 65.4–74.5) had delivered at health facility and 117(29.9%) delivered outside. 275 (72,2%) (95% CI: 65.4–74.5) had three or more PNC, and 106 (27,8%), had less. There was association between the less than four ANC and the age of women (AOR, 0. 007, 95% CI: 0.142−0.735, p = 0.007), delaying more than hour to reach the health facility (AOR, 2. 517, 95% CI: 1.327−4.773, p = 0.005), and weak knowledge on the frequency of ANC (AOR, 2. 455, 95% CI: 1.47−4.099, p = 0.001). There was association between not attending institutional delivery and the women’s lack of commitment with religion (AOR, 3. 056, 95% CI: 1.332−7.012, p = 0.008), women’s primary education level (AOR, 5. 635, 95% CI: 1.114−28.505, p = 0.037) and women not satisfied with ANC services (AOR, 2. 257, 95% CI: 1.174−4.341, p = 0.015). There was association between less than three PNC visits and women status of married (AOR, 0. 040, 95% CI: 0.015−0.104, p = 0.001). There is an urgent need for strategies to improve access to health services, by removing socio economic, cultural and structural barriers.