Prevalence and predictors of utilisation of maternal healthcare services among teenagers in Kamuli District, Uganda

The well-being of teenage mothers and their children depends on the accessibility and utilisation of Maternal and Child Health (MCH) services.Therefore, adequate access is essential to prevent pregnancy-related complications, enable early detection of risk factors, and support overall maternal and neonatal health.Teenage mothers in rural areas of low-and middle-income countries face numerous obstacles, including but not limited to stigma, discrimination, inadequate knowledge of available services, and long distances to health facilities.These barriers contribute to high rates of morbidity and mortality for both mothers and babies.In Uganda, only 53.1 % of teenage mothers attend a postnatal check-up within the first six days after delivery, compared to 61.4 % of all mothers.The utilisation of MCH services is disproportionately low in rural districts, such as Kamuli District in the Busoga region.Using a modern, patient-centred conceptual framework, this cross-sectional study aimed to provide an indepth analysis of MCH service utilisation among teenage mothers in Kamuli District, Uganda.A total of 338 teenage mothers and 6 key informants were enrolled.Univariate and multivariate analyses related to MCH service utilisation were conducted using STATA 15.Independent variables included factors related to the ability to perceive the need for care, seek care, reach services, pay for services, and engage with MCH services.Qualitative data were assesed using deductive thematic analysis.MCH service utilisation was defined as birth attendance and postnatal care by a skilled attendant for a birth that occurred in the 12 months preceeding the study.The mean age of participants was 17.7 (1.3) years, with the majority being older teenagers (18-19 years) at the time of their most recent delivery (198, 58.6 %).Most participants (295, 87.2 %) had skilled birth attendance; however, less than half (132, 39.1 %) received full postnatal care.In the multivariable analysis, the only factors significantly associated with MCH service utilisation were knowledge of maternal risks, having a relative who influenced MCH-related decision-making, and having sufficient income.Motivation, perceived quality of care, availability, accessibility, affordability, and approachability also influenced MCH service utilisation.Overall, the utilisation of MCH services by teenage mothers was suboptimal.Improving the design and reach of teenage-friendly interventions may improve access to MCH services among this group.Additionally, increasing health awareness may help reduce the stigma associated with teenage pregnancy.