Sub-national analysis and determinants of numbers of antenatal care contacts in Nigeria: assessing the compliance with the WHO recommended standard guidelines

Abstract

Background Nigeria has unimpressive maternal and child health indicators. Compliance with the WHO guidelines on the minimum number of antenatal care (ANC) contacts could improve these indicators. We assessed the compliance with WHO recommended standards on ANC contacts in Nigeria and identify the associated factors. Methods Nationally representative cross-sectional data during pregnancy of 21,785 most recent births within five years preceding the 2018 Nigeria Demographic Health Survey was used. The number of ANC contacts was categorised into “None”, “1–3”, “4–7” and “8 or more” contacts based on subsequent WHO guidelines. Descriptive statistics, bivariable and multivariable multinomial logistic regression was used at p = 0.05. Results About 25 % of the women had no ANC contact, 58 % had at least 4 contacts while only 20 % had 8 or more ANC contacts. The highest rate of 8 or more ANC contacts was in Osun (80.2 %), Lagos (76.8 %), and Imo (72.0 %) while the lowest rates were in Kebbi (0.2 %), Zamfara (1.1 %) and Yobe (1.3 %). Respondents with higher education were twelve times (adjusted relative risk (aRR): 12.46, 95 % CI: 7.33–21.2), having secondary education was thrice (aRR: 2.91, 95 % CI: 2.35–3.60), and having primary education was twice (aRR: 2.17, 95 % CI: 1.77–2.66) more likely to make at least 8 contacts than those with no education. Respondents from households in the richest and middle wealth categories were 129 and 67 % more likely to make 8 or more ANC contacts compared to those from households in the lowest wealth category respectively. The likelihood of making 8 ANC contacts was 89 and 47 % higher among respondents from communities in the least and middle disadvantaged groups, respectively, compared to the most disadvantaged group. Other significant variables were spouse education, health care decision making, media access, ethnicity, religion, and other community factors. Conclusions Compliance with WHO guidelines on the minimum number of ANC contacts in Nigeria is poor. Thus, Nigeria has a long walk to attaining sustainable development goal’s targets on child and maternal health. We recommend that the maternal and child health programmers should review existing policies and develop new policies to adopt, implement and tackle the challenges of adherence to the WHO recommended minimum of 8 ANC contacts. Women's education, socioeconomic status and adequate mobilization of families should be prioritized. There is a need for urgent intervention to narrow the identified inequalities and substantial disparities in the characteristics of pregnant women across the regions and states.

Determinants of optimal antenatal care visit among reproductive age women in Low and Middle Income Countries; Evidence from recent demographic health survey: application of a multilevel binary logistic regression model

“…Women and their partners with higher levels of education have a higher likelihood of receiving optimal ANC visits. This nding is consistent with previous research [3,36,[45][46][47][48][49]. This is because education improves health-care utilization and increases knowledge about speci c issues.…”

“…Individuals who had access to the media (reading newspapers or magazines, listening to the radio, and watching television) had a higher chance of using ANC than those who did not. This nding is in agreement with studies [49,61,70,73]. Individuals with access to local media were also more likely to seek medical attention [74].…”

Timing of first antenatal care contact, its associated factors and state-level analysis in Nigeria: a cross-sectional assessment of compliance with the WHO guidelines

“…Variables that were significant at p<0.20 were included in the multivariable model. 31 The multinomial logistic regression model computes the maximum-likelihood estimates of the probability of success of an event. In the binary logistic regression, the ORs are computed as the ratio of odds of success divided by the odds of failure, the i th coefficient is…”

“…In Nigeria, according to Fagbamigbe et al, only a quarter of pregnant women had no ANC contact, 38% had 4-7 visits and 20% up to 8 ANC contacts. 31 The current study is designed to provide an up-to-date assessment of the timeliness of ANC initiation in Nigeria and the factors that drive the timing of the first ANC contact. Also, this study serves as a response to the United Nations call for continuous monitoring and evaluation of countries' closeness to the achievement of the SDGs.…”

A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

“…The earlier the initiation of ANC contacts, the higher the prevalence of having a higher number of ANC components. Fagbamigbe et al had already suggested that early initiation of ANC contacts and having a su cient number of contacts may increase the number of components of ANC received [49]. Also, the higher the number of ANC contacts made, the higher the prevalence of having a higher number of ANC components.…”