Spatial accessibility of continuous maternal and perinatal healthcare services in Mozambique

Abstract Maternal and perinatal healthcare remain insufficient in impoverished regions such as sub-Saharan Africa (SSA), and removing geographic barriers to access continuous maternal and perinatal healthcare services (CMPHS) has been addressed as a critical strategy. Based on the framework of maternal, neonatal, and child health (MNCH) proposed by WHO, access to CMPHS in Mozambique was assessed as the integration of three independent service packages, namely antenatal care (ANC), institutional delivery (ID), and postnatal care (PNC). We perform a spatial overlap analysis to identify eight types of multi-level healthcare access zones and reveal the geographic barriers for women of reproductive age (WoRA) reaching CMPHS. We find that access to reaching ANC, ID, and PNC varied significantly, with access to ANC being the best and PNC being the worst. More than 51% of the WoRA were not able to access any service package as part of CMPHS, while only about 21% could access CMPHS in a timely manner. Similar research should be carried out in SSA countries to identify resource shortage area and successful experiences should be learned to broad CMPHS coverage with particular focus.