The Interplay of Digital Access and Socioeconomic Inequality in Maternal Health Service Utilization in Togo: Evidence from the Multiple Indicator Cluster Survey using Survey-Weighted Analysis

Background Maternal mortality continues to cause a significant public health challenge in Togo, where inequalities in access, continue to reflect both socioeconomic and digital divides. With the rapid expansion of mobile and internet technologies, understanding how these factors interact with traditional determinants such as education, wealth, and residence is a crucial need for designing and implementing health interventions for all. Hence, this study aimed to analyze the influence of digital access (media exposure, internet use, and mobile phone use) after controlling socioeconomic and demographic characteristics, on maternal health-seeking behaviors such as Antenatal Care (ANC ≥ 4 visits), facility delivery, and Post Natal Care (PNC) within 48 hours. Methods This study analyzed Togo’s latest Multiple Indicator Cluster Survey (MICS) data available (2017). A total of 7,326 weighted observations were analyzed using survey-weighted binary logistic regression to identify predictors of maternal health service utilization. An interaction analysis and sensitivity analysis were performed to evaluate the variation of significance in place of residence as well as the robustness findings. All models accounted for the complex sampling design and adjusted for potential confounders. Results Overall, 57.1% of women had four or more ANC visits, 79.6% delivered in a health facility, and 66.7% received PNC within 48 hours. After adjustment, mobile phone use was strongly associated with adequate ANC utilization (AOR = 1.89; 95% CI: 1.44–2.47; p < 0.001). For facility delivery, women with primary [Adjusted Odds Ratio (AOR) = 1.79; 95% CI: 1.20–2.67; p = 0.0046] and secondary or higher education (AOR = 3.97; 95% CI: 2.17–7.25; p < 0.001) had significantly higher odds compared to those with no education. Urban women (AOR = 3.34; 95% CI: 1.34–8.34; p = 0.010), those in richer quintiles were more likely to deliver in facilities. For PNC, media exposure (AOR = 0.72; 95% CI: 0.53–0.96; p = 0.026), higher parity (AOR = 0.66; 95% CI: 0.44–0.99; p = 0.044), and lower education levels were associated with lower PNC attendance within 48 hours. Sensitivity and interaction analyses confirmed the robustness of the main findings. Conclusion Digital access influences, but does not replace, the impact of education, wealth, and residence on maternal health-seeking behaviors. Expanding mobile connectivity and targeted digital literacy, especially among poorer and rural women, could strengthen equitable access to maternal health services across Togo. Trial Registration Not applicable.