What Explains the Rural − Urban Inequalities in Maternal Health Services Utilization in Tanzania? A Fairlie Decomposition Analysis

Introduction: Maternal mortality remains a public health issue in developing countries, with rural areas having higher rates as compared to the urban areas. Since effective utilization of maternal health‑care services has the potential to reduce maternal mortality, this study measures the factors contributing to the existing rural − urban differences in the utilization of maternal healthcare services in Tanzania. Methods: We used Tanzania Demographic and Health Survey 2015/2016 data. Multi‑stage stratified sampling was used to select the study participants and we estimated a Fairlie decomposition to understand the factors that contribute to inequality in maternal health‑care services utilization between the rural and urban areas in Tanzania using Stata 17. Results: The study findings revealed a considerably wide rural‑urban disparity in the utilization of maternal health‑care services. As the findings indicated, household wealth status is the major factor for that disparity. Other factors are women’s exposure to the media, women’s working status, and distance from the homesteads to the health facilities. Conclusion: Therefore, any policy geared toward bridging the gap between the rural and urban areas in the utilization of maternal health‑care services should focus on empowering women in terms of household economic status, media exposure, and employment.