Previous research studies reveal that utilization of health services vary systematically among individuals and communities. There are a number of factors that influence the utilization of services, including the availability of services, quality and cost of services, and other social factors. The total fertility rate in the Gaza strip is among the highest rate in the world. In pursuit of reducing the total fertility rate, the MOH and UNRWA offer maternal and children health services and family planning services free of charge. However, the utilization of family planning services is far below.
The goals of this research are to study the factors that determine the utilization of maternal and child health care services, utilization of family planning services, and contraceptive use in the Gaza strip. There are several theoretical reasons to expect a relationship between utilization of maternal and child health services and subsequent increases in family planning services utilization and contraceptive use. Therefore, this study aims to also study the impact of maternal and child health services utilization on the subsequent utilization of family planning.
[...] In their work, which examined the impact of simultaneity in the use of maternal and child health care in developing countries, Ahmed and Mosley found an association between the utilization of MCH services and the use of contraceptive (Ahmed & Mosley, 2002). Furthermore, the findings of their study have proven that families develop a joint demand for high quality health care services and limited family size. The outcomes of this joint demand are more utilization of maternal and child health services for both mothers and children and more use of contraceptives (Ahmed and Mosley, 2002). [...]
[...] In developing countries, many initiatives have launched to encourage utilization of family planning services, including the integration of services for both maternal and child health care (MCH) and family planning. MCH is an essential health care service based on practical, scientifically sound, and socially acceptable methods. Generally, in the majority of developing countries, family planning and MCH services operate under Ministry of Health and the implementation of services takes place in separate organizations without administrative collaboration (Seibera et al., 2005). [...]
[...] In the Gaza Strip, the two main providers of maternal and child health services are the MOH and the UNRWA (MOH, 2005). The MOH provides both MCH services and family planning services to all citizens(excluding refugees(through a network of primary health care centers. It provides perinatal care to all pregnant women free of charge, whether or not a woman has health insurance. The same is true for family planning services, but they are not free of charge and women must pay symbolic price. [...]
[...] This outcome variable quantifies use of contraceptive in two categories: respondents did not used family contraceptive between their last pregnancy and the survey time respondents used contraceptive between their last pregnancy and the survey time Intensity of maternal and child health services utilization for the last birth in the last two years Antenatal care visits: this outcome variable quantifies number of antenatal care visits in three categories: no visits, 1 to 4 visits, more than 4 visits Postnatal care visits: this outcome variable quantifies number of postnatal care visits in three categories: no visits, 1 to 2 visits, more than 3 visits Study limitations and threads to validity The main limitation of the study is the lack of appropriate data on service integration, which limits the ability of the study to test whether service integration influences the contraceptive behavior via MCH utilization. [...]
[...] Utilization MCH services and family planning is higher in urban areas than the rural areas Literature Review The utilization of health services is a complex behavior. According to Chakraborty et al., the use of health services is influenced by the availability, quality, and cost of services (Chakraborty et al, 2003). Other factors that influence the utilization of health services include: social structure, health beliefs, and individual characteristics (Sarin, 1997). Zerai and Tsui found that women's current age, years of education, number of previous pregnancies, family size, household income, and socioeconomic status are important determinants of utilization of MCH services, as well as to family planning services utilization and contraceptive use (Zerai & Tsui, 2001). [...]
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