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      <JournalTitle>African Journal of Health Economics</JournalTitle>
      <Volume-Issue>Volume 7 issue 2</Volume-Issue>
      <Season>December 2018</Season>
      <ArticleType>Review &amp; Research</ArticleType>
          <FirstName>Akarawak Eno Emmanuella*</FirstName>
      <DOI>http://doi.org/10.35202/AJHE.2018.7200916 </DOI>
      <Abstract>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.&#13;
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.&#13;
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.&#13;
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.</Abstract>
      <Keywords>Maternal mortality, Maternal Health Care Services, hierarchical modelling, socio-demographic factors, healthcare utilization</Keywords>
        <Abstract>https://ajhe.org.in/ubijournal-v1copy/journals/abstract.php?article_id=6284&amp;title=AN APPLICATION OF HIERARCHICAL LOGISTIC MODELLING TO MATERNAL HEALTHCARE UTILIZATION IN NIGERIA</Abstract>
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