Background: Equity is an ethical concept. Equity in healthcare includes equal access to available care for equal need, and equal quality of care for all. The collapse of the Cooperative Medical System left many of the rural poor uninsured and unable to access the services necessary to maintain good health leading to poor health service utilization. Objective: The current study aimed to assess equity of distribution and utilization of maternal health services between urban and rural strata in Zagazig district, Sharkia Governorate.
Methods: Cross sectional study through two stage cluster stratified random study technique was conducted on 400 married women in child bearing period. The calculated sample was collected from four primary health care facilities; these facilities were chosen randomly. Women were interviewed by predesigned questionnaire. Utilization rates were estimated. Assessment of inequity was carried out by simple and gradient measures.
Results: The study revealed that the utilization of antenatal full services and infant care services are higher in urban than rural health facilities 69.1 – 100% versus 7.8 4.3 %) according to the selected seven maternal health indicators. This was showed by significant difference in the indicators P ≤ 0.05. Universal geographical accessibility was confirmed with significant difference to financial accessibility regarding residence. There was high residence inequality in utilization of health services. Socioeconomic status affect variably on service utilization.
Conclusion: residence affect greatly on health services utilization, urban residence more likely to use health services more than rural one. Universal geographical accessibility was achieved but financial accessibility affected by residence. Residence inequity was confirmed. Socioeconomic status as a social determinant affects health service utilization equity with variable extent by positive or negative association.