Association between healthcare providers type and maternal-child healthcare services utilization in Pakistan: evidence from 2018 DHS using generalized structural equation modelling

Background: Healthcare provider's distributional shortages, especially in developing countries, result in a slowdown in progress towards better healthcare outcomes and achieving the Sustainable Development Goals (SDGs-3). The objective of current research is to examine the influence of professional and non-professional healthcare provider distribution on maternal and child healthcare services among married women who may face structural and social barriers that limit their autonomy in seeking skilled maternal care in Pakistan. Methods: Bivariate and multivariate regression models were used for the 2018 Pakistan Demographic and Health Survey (PDHS) (N = 8287 women aged 15–49). The association between the distribution of healthcare providers, antenatal care visits (ANC), place of delivery, and postnatal care visits (PNC) for mothers and children was measured by three types of healthcare provider’s distribution, including no care, non-professional, and professional healthcare providers. All the investigations were performed using STATA V.16.1. Results: Around 50.7% of mothers have less than three ANC visits, and 49.3% of women have four or more ANC visits. 67% of women have medical facility delivery, whereas the remaining 33% have non-medical facility delivery. Around 69.9% of women have no PNC visit, 5.8% visited non-professional, and the remaining 24.3% visited professional healthcare providers for PNC visits individually. The regression outcomes revealed that professional healthcare providers were positively and significantly associated with the increased number of ANC visits, medical facility delivery, and postnatal checks for mothers and children. Additionally, non-professional healthcare providers were also positively and significantly connected with the number of ANC visits and postnatal checks for mothers by non-professionals. Conclusion: Our findings demonstrate that professional healthcare provider’s distribution indicates a positive and significant association with maternal and child healthcare outcomes. This suggests the need for tailored interventions for the distribution of healthcare providers and promoting maternal education, empowering women's decision-making especially in remote areas, to improve maternal and child healthcare utilization services (MCH) and healthcare outcomes.