In a new analysis led by early researcher Lena Wessing and colleagues from Karolinska Institutet (Sweden), Institute for Tropical Medicine (Belgium) and Muhimbili University of Health and Applied Sciences (Tanzania), we examined socioeconomic inequalities in hospital births among higher-risk pregnant women in urban Tanzania, using data from the 2022 Tanzania Demographic and Health Survey.

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We found that:

• Over half (54.9%) of urban facility births took place in hospitals, but richer women had nearly twice the odds of delivering in a hospital compared to poorer women.
• Inequalities were largest among first-time mothers: 58.5% of poorer vs. 74.3% of richer nulliparous women used hospitals for childbirth.
• Despite good physical access to hospitals and officially free maternity services, wealth-related disparities persist across all parity levels.
• Improving hospital use among poor, higher-risk women will require measures such as reducing indirect costs, strengthening referral systems, and improving the quality of primary-level care.

The pre-print of the paper, “Socioeconomic inequalities in hospital births among higher risk pregnant women in urban Tanzania: analysis of the 2022 Tanzania Demographic and Health Survey”, is available here.

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