Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey
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Date
2018-05-21
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Publisher
Public Library of Science one (PLoS), United States
Abstract
Introduction
Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy
outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized.
This study investigates the prevalence and factors associated with underutilization of
ANC services with a focus on the differences between rural and urban residences in
Nigeria.
Methods
We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for
the sampling weight and the cluster design of the survey. The prevalence of underutilization
of ANC was assessed using frequency tabulation while associated factors were examined
using Chi-Square test and multivariable logistic regression analysis.
Results
The prevalence of underutilization of ANC was 46.5% in Nigeria, 61.1% in rural residence
and 22.4% in urban residence. The North-West region had the highest prevalence of ANC
underuse in Nigeria at 69.3%, 76.6% and 44.8% for the overall, rural and urban residences
respectively. Factors associated with greater odds of ANC underuse in rural residence were
maternal non-working status, birth interval 24 months, single birth type, not listening to radio at all, lack of companionship to health facility and not getting money for health services.
In urban residence, mothers professing Islam, those who did not read newspaper at
all, and those who lacked health insurance, had greater odds of ANC underuse. In both rural
and urban residence, maternal and husband's education level, region of residence, wealth
index, maternal age, frequency of watching television, distance to- and permission to visit
health facility were significantly associated with ANC underuse.
Conclusions
Rural-urban differences exist in the use of ANC services, and to varying degrees, factors
associated with underuse of ANC in Nigeria. Interventions aimed at addressing factors identified
in this study may help to improve the utilization of ANC services both in rural and urban
Nigeria. Such interventions need to focus more on reducing socioeconomic, geographic and
regional disparities in access to ANC in Nigeria.
Description
Keywords
Antenatal care, prevalence, Rural-urban difference, health facility, disparities
Citation
Adewuyi, E.O., Auta, A., Khanal, V., Bamidele, O.D., Akuoko, C.P. & Adefemi, K. (2018): Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey. PLoS ONE 13(5): e0197324. Publisher: Public Library of Science one (PLoS), United States. Available online at https://doi.org/10.1371/journal. pone.0197324.