Globalisation and Maternal Health Care Utilisation in sub-Saharan Africa: A Bayesian Multilevel Analysis

Abstract Background Globalization is considered a major structural determinant of health and health care outcomes across the world. This study examines the influence of globalisation on maternal healthcare utilisation in sub-Saharan Africa. Methods Cross-sectional pooled survey data from 34 Demographic and Health Surveys (DHS) with 22559 randomly selected women of reproductive age group with a recent birth were combined with country-level globalisation indices from the KOF Swiss Economic Institute. Bayesian multilevel models were applied on maternal health care utilisation indicators (antenatal care visits, institutional delivery, and postnatal care check-ups) in relation to three dimensions of globalisation indices (economic, social, and political) and selected covariates. Results The results from the study demonstrate that the influence of globalisation on maternal healthcare depends on the dimension of globalisation. After controlling for selected individual and community-level factors, social globalisation is significantly associated with all the indicators of maternal healthcare utilisation while economic globalisation is significantly associated with antenatal care and postnatal check-ups for mothers and new-born babies. Conclusion More consideration in terms of public policy and further research, should be given to dimensions of globalisation which are more likely to influence maternal healthcare utilisation in sub-Saharan Africa.