Personal and environmental predictors of the intention to use maternal healthcare services in Kalomo, Zambia

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  1. Cephas Sialubanje1,2,*,
  2. Karlijn Massar2,
  3. Davidson H. Hamer3,4,5 and
  4. Robert A. C. Ruiter2

  1. 1Monze District Medical Office, Ministry of Health, P.O. Box 660144, Monze, Zambia, 2Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, 3Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia, 4Centre for Global Health and Development Boston University, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118,
    USA and 5Department of Global Health, Boston University School of Public Health, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston,
    MA 02118, USA
  1. ↵*Correspondence to: C. Sialubanje. E-mail: cephas.sialubanje{at}maastrichtuniversity.nl
  • Received January 29, 2014.
  • Accepted August 28, 2014.

Abstract

Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The
purpose of this study was to identify important factors influencing women’s intention to use these services in Kalomo, Zambia.
An interviewer-administered questionnaire was used to collect data from 1007 women of reproductive age (15–45 years) from
13 rural health centres with the lowest service utilization rates in the district. Questions included measures of (past) healthcare
seeking behaviour, psychosocial variables (attitude, perceived social norms, perceived behavioural control), logistical barriers
(e.g. distance to the clinic) and sociodemographic variables (e.g. age, income and education level). Overall, our findings
showed that most respondents had high intention to use healthcare services. Intention was positively associated with attitude,
personal norms, behavioural control, education and income levels. Conversely, intention was negatively related to perceived
social norms, age and distance. Multivariate regression analysis showed that, together, these variables accounted for 41.8%
of the variance in intention, with perceived behavioural control being the strongest predictor of intention, followed by geographical
distance and perceived social norms. These findings suggest that public health programmes mitigating these important factors
are likely to motivate pregnant women to use maternal healthcare services.

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