Date of Conferral

8-6-2025

Degree

Ph.D.

School

Public Health

Advisor

Raymond Panas

Abstract

Maternal mortality remains one of the leading public health issues in Zambia characterized by elevated maternal mortality rates among women of reproductive age. This research study investigated the effect of birth spacing, province type and location, and maternal health services utilization on maternal deaths among women in the Lusaka, Eastern, Central, and North-Western provinces of Zambia. The theoretical underpinning of this investigation drew upon the social-ecological systems framework. Using secondary data from the 2018 Zambia Demographic and Health Survey (ZDHS) of 1,868 women aged 15–49 years, the study adopted a quantitative, descriptive, cross-sectional research design. Binary logistic regression analysis revealed regional disparities with significantly lower likelihoods of maternal mortality in the Eastern, Luapula, and Western provinces. A significant reduction in the odds of maternal mortality was observed across all six regression models for each province (Eastern: OR range = 0.613–0.658 ; p < 0.05; Luapula: OR range = 0.533–0.552; p < 0.05; Western: OR range = 0.550–0.582; p < 0.05), when controlling for age, education, and type of place of residence. In contrast, neither birth spacing, province type, nor maternal health services utilization demonstrated a significant effect on maternal mortality. These findings underscore the importance of investigating additional socioecological factors which may be associated with these provincial disparities. The results of this study have positive social change implications in raising awareness to provincial differences in maternal mortality and the potential to improve health outcomes for all women across Zambia.

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