Abstract
IntroductionUtilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average.MethodsWe analysed the 2013 Nigeria DHS to determine factors associated with utilization of these health MCH indicators by employing both bivariate and multivariate logistic regressions.ResultsOverall, 54% of women had at least four ANC visits, 37% delivered in health facility and 29% of new born had postnatal care within two of births. Factors that consistently predict the utilization of the three MCH services are maternal and husband's level education, place of residence, wealth level and parity. Antenatal care strongly predicts both health facility delivery (OR = 2.16, 95%CI: 1.99-2.34) and postnatal care utilization (OR = 4.67, 95%CI: 3.95-5.54); while health facility delivery equally predicting postnatal care (OR = 2.84, 95%CI: 2.20-2.80).ConclusionImproving utilization of these three MCH indicators will require targeting women in the rural areas and those with low level of education as well as creating demand for health facility delivery. Improving ANC use by making it available and accessible will have a multiplier effect of improving facility delivery which will lead to improved postnatal care utilization.
Highlights
Utilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average
Recent estimates show that the overall ante-natal care (ANC) coverage in Nigeria stood at 61% which is an abysmal three percentage points increase from 58% a decade ago; 36% of deliveries were delivered in a health facility while only 14% of newborns received postnatal care within two months of delivery [1]
About 54% of women had at least four ANC visits during their last pregnancies five year period before the survey; 37.3% delivered in a health facility and 28.9% of newborn babies received postnatal care within two months of delivery
Summary
Utilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average. The ANC coverage of 61% falls short of the recommended 90% of ANC coverage required to reduce most deaths among mothers and their newborn [2] This national average conceals major variations between rural and urban areas as well as between states and geopolitical zones within the country. Institutional delivery show similar regional and rural/urban disparity where it is highest in urban areas (63%) than in rural areas (23%); highest in South West zone (76%) and lowest in North West (12%); the consequence of these differentials of coverage in ANC is that maternal and child health mortality remains high (as well as other indicators of maternal and child health) at national level despite the co-existence of high national coverage in ANC [1]. These figures show a reduction of between 20% and 31% in the past decade but not enough to achieve MDGs 4 and 5 [1]
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