Maternal health service utilization, determinants, and perceived barriers among adolescent mothers residing near level-1 hospitals in lusaka, zambia

Insufficient utilization of maternal healthcare services can lead to adverse maternal and child health outcomes, especially for adolescent mothers. The World Health Organization recommends four or more antenatal-care visits, skilled-birthattendance, and postnatal-care within six weeks after childbirth. Level-1 hospitals in Zambia are crucial for maternal healthcare services, but their optimal utilization requires accessibility, affordability, and high-quality services. This study investigates maternal healthcare service utilization, perceived barriers, and associated factors among adolescent mothers near Level-1 hospitals in Lusaka, Zambia. A Total of 413 mothers aged 19 and below, selected through convenience sampling, were interviewed. Qualitative and quantitative analysis were conducted on the data collected through a structured questionnaire. The mean age of respondents was 17.52 years; nearly 49.2% lived in suburban areas, and 60% were married. Educationally, 40.4% had not completed secondary school and 69.7% were from low-income households. Nearly 48.4% believed that maternal healthcare services were readily available in hospital, and 54.2% had interacted with community health workers during their last pregnancy. Regarding previous pregnancy intentions, 42.4% expressed no intention, but 81.6% were not using contraception. Nearly 42.6% began antenatal-care visits during the second trimester of pregnancy, and only 48.4% had four or more visits. Almost 84.5% of deliveries were by skilled-birthattendants, and 65.6% occurred at hospitals. About 68% had received postnatal-care. However, 38.7% comprehensively utilized all three maternal healthcare services. Urban residence, higher education, higher income, prior maternal healthcare knowledge, and contact with community health-workers were associated with increased utilization. Adolescent mothers encounter barriers to accessing maternal healthcare due to distance, transport, waiting times, privacy, cultural norms, inadequate information, costs, facility cleanliness, infrastructure quality, and provider competence and conduct. These factors impact utilization. The finding emphasizes the importance of interventions like sexual education, youth-friendly healthcare, and supportive policies. Collaboration among government, civil society, and international partners is vital for fostering an adolescent-friendly maternal healthcare environment. Keywords: Adolescent mother, barriers, maternal health care, services utilizations, Zambia