Factors associated with the underutilization of Community Relay Healthcare Services by mothers in Benin

Abstract

Introduction: A community relay is a volunteer from the local community trained to raise awareness, provide advice, and support people by promoting health and access to healthcare services. Their role is critical in facilitating access to primary healthcare in Benin, especially in rural areas with limited health infrastructure. However, the use of their services remains suboptimal despite efforts by the Ministry of Health to strengthen their capacity, motivation, equipment, and to integrate them into health programs to improve their performance in the field. This study determined factors associated with the non-use of healthcare services provided by Community Relays. Methods: A cross-sectional study was conducted among 448 mothers of children under five in areas covered by the High-Impact Community-Based Interventions Package (PIHI Com) selected using simple random sampling. A multistage random sampling method was used to select the participants. The data were collected using a digital form administered by investigators and analysed using logistic regression. Results: Among the mothers surveyed, 55.6% (249/448) reported not using community relay services. Multivariate analysis revealed that not using these services was significantly associated with a lack of awareness (adjusted OR = 5.5; 95% CI: 2.7–11.1) of the PIHI Com program and the services provided by community relays. Additionally, mothers living in the central (aOR= 3.5, 95%CI = 1.7-7.3) or southern (aOR = 2.9, 95%CI = 1.5-5.9) regions were less likely to use these services than those living in the northern region. Conclusion: Enhancing communication strategies and aligning services with local needs may increase the utilization of community-based services, ultimately contributing to the reduction of maternal and child mortality.