World-Systems Analysis and Postnatal Care Utilization among Periphery Women

Current cross-national research suggests that increased economic dependence by peripheral countries on core ones is associated with poor maternal health outcomes and greater socioeconomic inequalities in the periphery. However, not enough attention has been given to analyzing how this economic dependence—via foreign direct investment (FDI), importation, and exportation between peripheral and core nations—specifically influences periphery utilization of postnatal care. Utilizing a world-systems framework, this study examines data from the Tanzania Demographic Health Survey (TDHS) and World Development Indicators (WDI) from the World Bank to shed light on the detrimental impacts of economic dependence on Tanzania’s postnatal care utilization between 2010–2016. Findings show that data constructed around socioeconomic status, rural/urban residence, and region disclose noteworthy negative correlations for importation, exportation, foreign direct investment, and Tanzanian postnatal care utilization over 2010–2016. Even after controlling for these factors, it was observed that marginalized women in Tanzania continued to have significantly lower utilization of both mother's and newborn postnatal care during this period. Higher and statistically significant inequalities in the use of newborn postnatal care were also found for rural women with less than secondary education compared to urban women with the same education level. These findings highlight the need to consider economic dependence on core countries when crafting policies and strategies for addressing disproportional effects on postnatal healthcare utilization among underserved women in Tanzania.