Non-Utilization of antenatal care services among women of reproductive age in the Niger delta region of Nigeria: Findings from 2595 women

Abstract

The United Nations' Sustainable Development Goals and the World Health Organization (WHO) outline targets for the reduction of maternal mortality by 2030. Quality antenatal care is one of the three essential maternal health services which ensure good feto-maternal outcomes. The antenatal period provides ample opportunity for health workers to educate women, offer screening, diagnosis and treatment services for pregnancy-related conditions, and refer women for specialized interventions.This descriptive cross-sectional community-based household survey using multistage sampling technique describes the pattern of utilization of antenatal care services, the perception of respondents toward antenatal care and the determinants of utilization of antenatal care among a cohort of 2595 women of reproductive age in Rivers State. Data was collected using interviewer-administered questionnaires built on the Open Data Kit (ODK) application for android phones and analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0 statistical software.Antenatal care was poorly utilized. There was no association between level of education and utilization of antenatal care services. Women residing in urban locations (Adj O.R = 1.46; 95% C.I = 1.16 to 1.84) and women who were comfortable with the government health facility closest to their residence (Adj O.R = 1.72; 95% C.I = 1.36 to 2.17) had increased odds of utilizing antenatal care services. Married women had an increased odds of utilizing antenatal care services compared to unmarried woman Adj O.R=1.66; 95% C.I =1.30 to 2.11The implications of these findings underscore the need for fit-for-purpose interventions that address the barriers and modifiable determinants identified and should be considered when policymakers or international agencies plan the prevention of maternal morbidity and mortality in developing countries. Models of care that involve continuous health promotion activities within the communities, health systems strengthening, community-based insurance schemes and a patient-centered approach to care have the potential to improve utilization of antenatal care services.

Factors Influencing the Utilization of Antenatal Services among Women of Childbearing Age in South Africa

“…This may be due to the support that married and cohabitating women receive from their husbands or partners as a result of the ANC attendance sensitization campaign, which equally targets men and encourages them to follow their wife or partner to the clinic [37]. This is also consistent with the data from similar studies [38,39].…”