Utilization of antenatal care in Nigeria - An analysis of patterns and trends from 1999-2008
Maternal and neonatal indices do not fully justify efforts put into promotion of antenatal care (ANC) in Nigeria over the years. This study set out to identify the patterns and trends of utilization of ANC in a bid to evaluate the direction of progress and thus recommend solutions that would ultimately address gaps in the implementation of ANC.
METHODS:
This study reanalyzed datasets from the Nigerian Demographic and Health Surveys (NDHS) of the years 1999, 2003 and 2008. Data was summarized as proportions to demonstrate trends in utilization of ANC services. Chi square for trends was used to assess association between variables with level of significance set at 5%.
RESULTS:
Majority of the respondents had no form of formal education (49.3%, 49% and 49.2%) and were rural dwellers (70.5%, 64.2% and 73.2%) in 1999, 2003 and 2008 respectively. Overall, the proportion of women utilizing antenatal care dropped from 69% in 1999 to 61% in 2008. Of women utilizing ANC, those with at least four ANC visits declined marginally from 84.3% in 1999 to 82.1% in 2008. Though about three quarters of women had at least one ANC provided by a skilled attendant, this figure reduced by 3- 15% between 1999 and 2008. Over 80% of women had routine examinations and procedures, however those who took antimalaria drugs decreased from 52.3% (2003) to 31.9% (2008). There was a statistically significant decrease in ANC utilizationacross all socioeconomic and regional subgroups between 1999 and 2008 (P< 0.01) except among those with tertiary education (p=0.389).
CONCLUSIONS:
There is a steady decline in proportion of women utilizing ANC services in Nigeria with some gains in quality where it is being provided. Key stakeholders need to put all hands on deck to improve access, educate women and healthcare workers and address socioeconomic barriers preventing ANC utilization.