ajheAfrican Journal of Health EconomicsCoVolume 7 issue 2MultidisciplinaryEnglishDecember 2018NNY-00011130Review & Research AN APPLICATION OF HIERARCHICAL LOGISTIC MODELLING TO MATERNAL HEALTHCARE UTILIZATION IN NIGERIA EnglishY1019Akarawak Eno Emmanuella*OgunniranEnglishNAdemolaJohnEnglishYhttp://doi.org/10.35202/AJHE.2018.7200916 Background: With a maternal mortality rate of 576 deaths per 100,000 live births, Nigeria accounts for about 10% of all maternal deaths, globally, and has the second highest mortality rate in the world. This high mortality rate makes maternal health a huge public health problem in the country. This paper, therefore, aimed at investigating socio-demographic factors affecting the utilization of Maternal Health Care (MHC) in the context of hierarchical modelling. Methods: Data were extracted from the Nigerian Demographic and Health Survey, 2013. The data have a hierarchical structure, with the 20,116 Ever-Married Women nested within their respective states of residence. Three different hierarchical logistic regression models were formulated to allow for comparison of outcomes between clusters. Findings: A proportion of opposed odds ratio of 0.45 indicate that in 45% of pair-wise comparisons between the urban and rural residence, the odds of MHC utilization was higher at an urban residence than at a rural residence by 1.388 times. The Median Odds Ratio (MOR) for Model 2 indicated the odds of MHC utilization was less than 2.41 for a woman in a state at higher risk compared to a different woman in a state at lower risk. The intra-class correlation coefficient revealed a 40% (Model 1), 21% (Model 2) and 16% (Model 3) chances of utilizing MHC, explained by between-states differences, respectively. Conclusion: In order to close the variation in healthcare delivery in Nigeria, there is a need for government to execute state-specific interventions that would allow fair distribution and utilization of MHC.EnglishMaternal mortality, Maternal Health Care Services, hierarchical modelling, socio-demographic factors, healthcare utilizationhttps://ajhe.org.in/admin/abstract?id=6284References1619Nigerian Demographic Health Survey: Individual Recode Documentation. 2013 WHO. Trends in Maternal Mortality: 1990-2010. 2012. Available from: https://www.who.int. Shrestha G, Shrestha G. Mathematical modeling of health service data using multiple logistic regression. BRAC University Journal. 2011; 8(1and;2): 47-54. Adewara JA, Ogunniran AJ, Onyeka-Ubaka JN. Modeling of maternal healthcare services using multinomial logistic regression. University of Lagos Journal of Medicine, Science and Technology. 2014; 2(1 and; 2): 41-55. Available from: http://196.45.48.93/index.php/ujmst/article/view/97. 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