Inequities in maternal and child health pose significant challenges to overall health improvement. Despite the preventable nature of most maternal and child deaths, these challenges persist, leading to poor maternal and child health outcomes. Compared to several high-income countries that have successfully attained their Sustainable Development Goal targets, Sub-Saharan Africa and Zambia, in particular, have experienced slower progress. Maternal health care utilisation has been shown to be a cost-effective measure in managing maternal health. However, research on the continuum of maternal health care utilisation and outcomes, especially within the Zambian context, remains limited. In a patriarchal country like Zambia, understanding the influence of gender, household, and socioeconomic factors is crucial for addressing these inequities and improving maternal and child health outcomes.

This study focuses on highlighting the population-level burden of morbidity among reproductive-age women and investigating the underlying socioeconomic and household factors driving inequities in continuum of maternal health care utilisation. By analysing data from the latest Zambia Demographic and Health Survey and conducting in-depth participant interviews, a contextual approach was employed to examine selected reproductive age morbidity and maternal healthcare utilisation outcomes.

The study reveals a high burden of reproductive age morbidity among women, with inequities playing a significant role. Maternal health disparities persist and are influenced by gender and household socioeconomic factors, leading to varying outcomes. Gender inequities affect the continuum of maternal health care utilisation, while household composition and structure have diverse effects, and should not be conflated when analysing maternal health care utilisation. To achieve Zambia Vision 2030 and Sustainable Development Goal 3, policy interventions should prioritise addressing these inequities and implementing equity-enhancing measures, thus working towards improved maternal and child health outcomes in Zambia.

Audrey Kalindi is a PhD candidate in the School of Demography at the ANU. She holds a Master’s and Bachelor’s degree from the University of Zambia (MA in Population Studies and BA in Demography and Economics). She has a Post Graduate Diploma in Monitoring and Evaluation from Stellenbosch University in South Africa. Her current research interests focus on maternal and child health inequalities.

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