Abstract
The study examined the effect of household socioeconomic status and other socio-demographic characteristics on antenatal care (ANC) utilization among 819 women within the reproductive ages across eight rural communities in Delta State, Southern part of Nigeria. Characteristics of the women were described using simple proportion and frequency. The chi-square test was used to examine factors that were significantly associated with a minimum of four (≥4) and eight (≥8) antenatal care contacts, which were respectively in line with the focused ANC and WHO's new guideline. The multivariable logistic regression was used to examine the determinants of a minimum of four and eight ANC. Statistical analyses were set at 5%. The results showed that 31.4% (257/819) and 2.2% (18/819) of mothers, respectively, made ≥ 4 and ≥ 8 ANC contacts in the course of their last pregnancies. According to the results, the odds for reporting 4≥ and ≥ 8 ANC improved with both wealth and educational attainment. Distance to the health center and cost are barriers to maternal care utilization and they reduce the odds for undertaking ≥ 4 and ≥8 ANC contacts. Women on higher media exposure were more likely to undertake ≥ 4 and ≥8 ANC contacts, and those on the highest media exposure were more likely to undertake ≥8 ANC contacts. Financing maternal care through health insurance and free maternal care significantly improves the odds to undertake ≥ 4 and ≥ 8 ANC contacts. Intervention programs should be designed to improve access to maternal care services and should expand education opportunities for mothers, improve household socioeconomic conditions, and encourage enrolment in health insurance and free maternal care in the study area.
Highlights
Recent evidence shows that annually 295,000 women die from pregnancy-related complications and that sub-Saharan Africa (SSA) and South Asia bear the brunt of global maternal death [1, 2]
The factors that are significantly associated with ≥ 4 antenatal contacts are maternal education, mass media exposure, time involved in walking to the nearest healthcare centers, and household wealth quintile (P < 0.10)
The factors that are significantly associated with ≥ 8 antenatal contacts are maternal education, mass media exposure, time involved in walking to the nearest healthcare centers, household wealth quintile, costs of care as barriers to maternal care utilization, knowledge of free maternal care services, and marital status (P < 0.10)
Summary
Recent evidence shows that annually 295,000 women die from pregnancy-related complications and that sub-Saharan Africa (SSA) and South Asia bear the brunt of global maternal death [1, 2]. Maternal mortality ratio (MMR) in SSA is calculated at 351 per 100,000 live births, and SSA. Women in the Reproductive-Age accounts for 66% of the global maternal-mortality burden [1]. The life-time risk of pregnancy-related deaths is one in 37 among LDCs when compared to one in 7,800 for developed countries [1]. Maternal mortality is a critical challenge in Nigeria. Between 56,000 and 58,000 Nigerian women die from pregnancyrelated complications. Recent evidence shows that the MMR in Nigeria at 917 per 100,000 live births [4]
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