regional inequalities and determinants of maternal care quality and utilisation in morocco: a public health and health systems analysis
1
Economics, Hassan II University, Casablanca, Morocco
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
maternal health remains a critical public health priority in morocco, where preventable maternal deaths persist despite national progress. regional disparities in antenatal care coverage, skilled birth attendance, and postnatal follow-up reflect inequities in women's health rights and access to essential services. evidence indicates that health literacy, socioeconomic status, and health system capacity strongly influence maternal outcomes. this study examines regional variations in maternal care utilisation and quality, and identifies determinants affecting service access.
METHODS:
we developed a multidimensional maternal care quality index using regional indicators from national health statistics for 2019-2023. variables included antenatal consultations by qualified personnel, facility-based deliveries, emergency obstetric services, and postnatal care. quantitative analysis employed logistic regression to assess associations between service utilisation and factors such as education level (proxy for health literacy), income, density of skilled health professionals, and availability of infrastructure.
RESULTS:
substantial regional disparities were identified, with antenatal care utilisation ranging from 68 to 98 percent. regions with greater density of midwives and improved obstetric capacity scored higher on the quality index. logistic regression showed that women's education was a strong positive determinant of adequate maternal care utilisation. economic vulnerability and shortages of qualified personnel were associated with reduced service access. disparities were most pronounced in regions with limited emergency care resources.
CONCLUSIONS:
regional inequities in maternal care utilisation and quality highlight the need for targeted health system strengthening in morocco. improving the distribution of skilled personnel, expanding emergency obstetric capacity, and enhancing women's health literacy are essential to advancing maternal health rights and reducing preventable mortality. policies should prioritise equitable resource allocation and community outreach to address persistent disparities.
maternal health remains a critical public health priority in morocco, where preventable maternal deaths persist despite national progress. regional disparities in antenatal care coverage, skilled birth attendance, and postnatal follow-up reflect inequities in women's health rights and access to essential services. evidence indicates that health literacy, socioeconomic status, and health system capacity strongly influence maternal outcomes. this study examines regional variations in maternal care utilisation and quality, and identifies determinants affecting service access.
METHODS:
we developed a multidimensional maternal care quality index using regional indicators from national health statistics for 2019-2023. variables included antenatal consultations by qualified personnel, facility-based deliveries, emergency obstetric services, and postnatal care. quantitative analysis employed logistic regression to assess associations between service utilisation and factors such as education level (proxy for health literacy), income, density of skilled health professionals, and availability of infrastructure.
RESULTS:
substantial regional disparities were identified, with antenatal care utilisation ranging from 68 to 98 percent. regions with greater density of midwives and improved obstetric capacity scored higher on the quality index. logistic regression showed that women's education was a strong positive determinant of adequate maternal care utilisation. economic vulnerability and shortages of qualified personnel were associated with reduced service access. disparities were most pronounced in regions with limited emergency care resources.
CONCLUSIONS:
regional inequities in maternal care utilisation and quality highlight the need for targeted health system strengthening in morocco. improving the distribution of skilled personnel, expanding emergency obstetric capacity, and enhancing women's health literacy are essential to advancing maternal health rights and reducing preventable mortality. policies should prioritise equitable resource allocation and community outreach to address persistent disparities.
| eISSN: | 2654-1459 |
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