ASSOCIATION BETWEEN UTILIZATION OF MATERNAL HEALTH CARE SERVICES AND CONTRACEPTIVE USE IN NIGERIA

Abstract

The antenatal period may be a woman's first contact with formal health education and health promotion interventions which impact on the health-care seeking behaviour, improved maternal, child and family health. It is an opportunity to introduce the woman to other reproductive health services and long-term use of these services. A woman may resume menses as early as 28 days postpartum. The uptake of family planning is low even in the post-delivery period when a woman is least desirous of another pregnancy and at risk of unplanned pregnancy. The early initiation of contraception is necessary to reduce the risk of unintended pregnancy and short birth intervals. Contraceptive knowledge and sensitization can be improved through quality antenatal care and counselling. To determine the association between antenatal/postnatal care and use of contraceptive.This is secondary data analysis using the National AIDS and Reproductive Health Survey 2012 (NARHS Plus II) data; a nationally representative cross sectional survey of men and women of reproductive age in Nigeria. The data on family planning use and method of family planning, antenatal care and post-natal care utilization were extracted for 6019 women pregnant in the preceding three years of the survey. Data was analysed using SPSS version 20.0. Descriptive statistics, Chi-square test and Binary Logistic regression was performed on the data extracted. The level of statistical significance was set at a p-value < 0.05 to show significant association between variables. The mean age of respondents in this study was 27.9 years(± 6.7). About a third of the respondents had no formal education (27.3%), 14.5% had primary education, 25.3% had secondary education. The respondents were mostly married (74.8%), from rural areas (56.5%) and monogamous family setting (53.8%). Many of the women had 3-6 children (37.1 %) and the last pregnancy was desired among 6 2 .5% of the women. Of the respondents, 52. 7% received antenatijl care by skilled health provider, 38.6% received postnatal care in the last pregnancy and 11.6% used a family planning method. The basic components of antenatal care including counselling on child spacing and breast-feeding were received by about half of the women. On logistic regression, women in the mid reproductive age group 25 -29 (OR=J.66; 95% CI= 1.02 - 2.69) and 30-34 years of age (OR=l.62; 95% CI= 1.02 - 2.60): and those who received child spacing counselling (OR= I. 78; 95% CI= 1.14 - 2.77) were more likely to use contraceptives. Women with no formal education or Quranic education {OR=0.23; 95% Cl= 0.13 - 0.46) or primary education (OR=0.47; 95% CI= 0.31 - 0.87) are less likely to use contraceptives among this population of women. Antenatal and post-natal care are important entry points for women into reproductive health programs. The quality of these services should be optimal for care in pregnancy and beyond including family planning. The use of contraception in the postdelivery and inter-pregnancy period can be influenced by quality maternal care with emphasis on contraceptive and family planning counselling in the antenatal, delivery and postnatal periods including intensity and frequency of the counselling.