MULTINOMIAL LOGISTIC REGRESSION OF FACTORS AFFECTING UTILISATION OF ANTENATAL CARE AMONG WOMEN OF PREMENOPAUSAL AGE IN NIGERIA

Abstract

Antenatal care (ANC) is the care a woman receives from healthcare professionals during pregnancy. In Africa, about 25% of maternal death occur during pregnancy which could be as a result of unsafe abortion, but mostly inadequate care during pregnancy. Studies have not really compared the sources of ANC with the factors affecting the utilisation of ANC and to what extent does these factors influence the source of ANC used. This study was based on the relationship between the factors affecting the utilisation of antenatal care and how these factors influence, the choice of antenatal care used compared to non-utilisation. This study was based on a cross-sectional study with data obtained from the 2013 Nigeria Demographic and Health Survey (NDHS). The NDHS data consists of 31,482 women, there were 2 files extracted: the children and couples files. Chi-square and Binary Logistic Regression were used to measure the relationship between the socio demographic factors and utilisation of ANC among women of premenopausal age and Multinomial Logistic regression was applied to investigate factors influencing the sources of antenatal care taken compared with non-utilisation of antenatal care. Out of all that interviewed, over 70% utilised antenatal care: health professionals, health associate professionals. Majority were young mothers (52%) and were from the North West (31.5%). Almost half had little education and almost 70% lived in the rural areas. Factors that were significantly associated with utilisation of ANC were religion, level of education and region. Furthermore, factors that were significantly associated with sources of ANC were Age, level of Education, Marital status, wealth index, region, place of residence, religion, and parity. However, there was a strong association between religion, region and antenatal care utilization (p<0.001 ). Also, there was a strong association between sources of ANC and education as no educated respondents will rather not utilized ANC compared to the educated (OR=18.53:95%CI=11.27-30.47), also a strong with parity as uniparous women are less likely not to utilise ANC compared to great grand multiparous women (OR=0.69:95%CI=0.58-0.81), · there is also association with region as non-utilisation is higher in the South South region (OR=5.69:95%CI=4.65-6.97) and less likely in the South East (OR=0.53:95% CI=0.39-0.72), and place of residence was also significantly strong as women in the rural areas are more likely to not utilise ANC (OR=l .87:95% CI=1.67-2.09). Religion, wealth index, level of education, region and type of residence are factors affecting utilisation of ANC. However, religion and region have a strong association with ANC utilization. Level of education, parity, place of residence and region have a strong association with sources of Antenatal care available and this association is statistically significant. Which means they can influence choice of Antenatal care to use.