Abstract
Many maternal deaths in Nigeria are as a result of pregnancy related complications that are preventable through utilisation of antenatal care facility. The World Health Organisation recommends at least four visits to an antenatal care facility to attain full life saving potentials for pregnant women and their unborn babies. As the deadline for the Millennium Development Goals (MDG 5), which focuses on maternal health and access to health facilities) approaches, it is important to evaluate the optimal utilisation of ANC and impact of regional differences. This study determined factors that affect optimal utilisation of ANC visits. The National Demographic and Health Survey, 2013 dataset on women aged 15-49 years who had their most recent birth in the last 5 years prior the survey was used for the analysis. Optimal utilisation of ANC was defined as four or more visits. Data were analyzed using Chi-square and binary logistic regression models (α=0.05). Mean age of women was 29±7 years and 53% achieved optimal utilisation. The identified predictors of optimal use of ANC were age, wealth index, number of children alive, and region among others. Women in the South-West were about 7 (OR=6.73, 955% CI=5.843, 7.758; p<0.001) times more likely to have had optimal utilisation of ANC than those in the North Central zone. This strength of relationship was retained after other socio-demographic factors were included in the regression model as control. Respondents aged 34-39 years were 2 times more likely to attain optimal utilisation of ANC facility compared to those aged 15-19 years (OR=1.50, 95% CI: 1.152, 1.946). Respondents who belong to the richest wealth quintile were about 3 times more likely to attain optimal utilisation of ANC visits (OR=2.86, 95% CI: 2.162, 3.775) compared to respondents in the poorest quintile. Optimal utilisation of ANC in Nigeria is still poor and differentials exist across the regions. Therefore, regional specific programmes targeting better utilisation of ANC visits among women should be provided particularly in the Northern part of Nigeria.
Highlights
Maternal morbidity and mortality occur due to complications during pregnancy and child birth
Optimal utilisation increased with increase in educational level; respondents with higher educational level had the highest proportion compared to respondents with no education (95.1% vs. 66.9%, p
Respondents from the North East geopolitical zone were less likely than respondents from the North Central zone to have optimal utilisation of ANC (OR=0.50, 95% CI: 0.455, 0.557)
Summary
Maternal morbidity and mortality occur due to complications during pregnancy and child birth. The World Health Organization (WHO) estimates that maternal mortality is over 500 000 deaths per year worldwide and 99 percent of these occur in developing countries. Nigeria accounts for about 10 percent of the world’s overall maternal mortality [1, 2]. Nigeria is among countries with high burden of Maternal Mortality globally. An estimated 800 women die every day from preventable pregnancy related causes [3]. Pregnancy related complications such as infections, eclampsia, and obstructed labour and maternal deaths may be effectively reduced through services obtainable in antenatal care services. Despite the benefits of antenatal care services, women do not utilize them optimally
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