Antenatal Healthcare Utilization and Maternal Health Outcomes in Rural African Setting: Evidence from Tanzania

Maternal health outcomes in rural Africa remain a critical concern, with inadequate antenatal care utilization exacerbating regional disparities and pregnancy-related risks. This study explores the relationship between antenatal healthcare utilization and maternal health outcomes in rural Tanzania using the 2015-16 Demographic Health Survey. A causal loop model was applied to analyze interrelationships and feedback among determinants, while zero-inflated Poisson and truncated regression models were used in handling overdispersion, accounting for excess zeros from non-utilizers, and addressing truncated distributions, ensuring precise analysis of healthcare utilization. Additionally, results show that there is a positive correlation (0.54, p < 0.05) between contraceptive use and women aged 15 to 35, emphasizing the importance of targeted family planning interventions. Additionally, early postnatal care attendance is identified as a critical factor, significantly reducing the occurrences of low birth weight (- 0.37, p < 0.05) and stillbirths (- 0.88, p < 0.05). Geographical distinctions reveal coastal zones outperforming other regions in maternal health outcomes, underscoring the necessity for tailored interventions, with disparities being due differences in regional's socioeconomic, and ethnicities background. Moreover, antenatal care demonstrates a positive and significant correlation with skilled delivery (0.36, p < 0.01), syphilis testing (0.21, p < 0.05), and early postnatal care (0.45, p < 0.01), while it exhibits a negative impact on stillbirth (- 0.26, p < 0.01) and low birth weight (- 0.10, p < 0.05), signaling the importance of antenatal services on improving maternal health outcome. The study recommends region-specific policy interventions, urging governments to address regional variations in maternal health indicators. Swift improvements are imperative in rural healthcare services. This entails expanding community health insurance schemes, leveraging women's social networks to deliver maternal health education, and increasing the participation and attendance of pregnant women in antenatal care services.