Residence Inequality of Maternal Health Service Utilization among Women in Somaliland: An Analysis from the Somaliland Demographic Health Survey in 2020

This study examines the factors influencing maternal health service utilization in Somaliland, where there is significant disparity in access based on place of residence. Previous studies indicate that women from higher-income households are more likely to use maternal health services. Using data from the 2020 Somaliland Demographic Health Survey (SLDHS), which included a weighted sample of 2,991 women of reproductive age from all six regions of Somaliland, the study investigates maternal health service utilization patterns. The results show that the majority of participants were aged 25-29 years, with a high percentage being married (94%) and having primary education (80.9%). A substantial portion of women lived in nomadic (38.1%) or rural (34.4%) areas, with 37.6% from the lowest wealth category. Among the women surveyed, 28.9% received antenatal care (ANC), 4.5% received postnatal care (PNC), and 76.8% delivered at home. Urban women had the highest utilization rates for ANC (48.15%), delivery (55.7%), and PNC (57.46%), while nomadic women had the lowest rates (ANC 13.39%, delivery 9.02%, PNC 11.94%). These results highlight significant geographical disparities in access to maternal health services, with urban women benefiting from considerably higher utilization rates. To address these inequities, it is recommended that policymakers implement targeted health programs for rural and nomadic populations, such as mobile health clinics and improved healthcare infrastructure.