FACTORS AFFECTING THE ACCESSIBILITY AND UTILIZATION OF ANTENATAL CARE IN NIGERIA

Abstract

Antenatal care coverage is indicator of access and use of health care during pregnancy. In developing country especially in Nigeria, there is still a low proportion on the accessibility and utilization of the system. The study seeks to investigate the level of antenatal care utilization and the level of home delivery among pregnant women in Nigeria and the associated factors using the 2013 Nigerian Demographic and Health Survey data. The 2013 Nigeria Demographic Health Survey (NDHS) consists of a nationally representative sample of 38,948 women age 15-49 years that were individually interviewed. From the secondary data, two dependent variables of interest were selected: Number of antenatal visit which will represent the level of antenatal care and Place of Delivery. The independent variables were socio demographic variables. Bivariate analysis was carried out to investigate association between each of the independent variables and the dependent variables. Multiple logistic regression analysis was used to examine the influence of the independent variables on level of ANC and on place of delivery. From a total number of 38,948 respondents, the mean age of women aged 15 - 49 years was 28.80±9.60 years. Antenatal utilization was 65%. Older women, urban residents, literate mothers, richest category of mothers, mothers who practiced Islamic &Christian religion, had the highest ANC utilization compared to the younger women, non-educated mothers. rural resident, and those who practiced other religion. Mothers from the South West &South East had the highest ANC utilization compared to other regions. Overall there was high prevalence of home delivery 75.3%, higher among the teenage and young mothers, rural residents illiterate mothers, poorest category of mothers, married mothers, mothers who practiced Islamic religion, and mother from the North West. This was greatly influenced by the six major reasons( no time as a result of sudden delivery,(time of onset of labour), was not necessary to deliver at the maternity clinic, health facility was too far or no means of transportation, health facility did not open, cost of care too much, not customary, for those married husband not allowing women to deliver in the maternity clinic). The level of home delivery is very high, so also the level of utilization of antenatal care is low. Government and Non-Governmental agencies to proffer strategies and create a programme and to attach incentives to the programs that will attach mothers to deliver at antenatal clinic Improvement in the educational opportunity for women in the rural areas, Government and Non-governmental agencies should attached incentives to the programs that will attach mothers to deliver at antenatal clinic and creation of awareness and sensitization among younger women.