AFRICAN JOURNAL OF HEALTH ECONOMICS - Volume 8 Issue 1, June 2019
Pages: 1-22
Predictors of Antenatal Care Utilization in Primary Healthcare Centers in Eight Rural Communities in Delta State, Nigeria.
Rolle R. Ahuru, Iseghohi Judith Omon
Category: Review & Research
Download PDF
Abstract:
Background: We examined the socio-demographic factors that influence early timing and an adequate number of ANC visits in Primary Healthcare Centers (PHCs) in eight randomly selected rural communities in Ughelli North Local Government Area (LGA), Delta State, Southern Nigeria.
Methods: The study was a cross-sectional household survey that enlisted 900 women within the reproductive ages. A structured questionnaire was used to elicit information from the respondents. Extracted data were analyzed with Stata version 13.0 for windows. Univariate, bivariate, and multivariate analyses were conducted.
Findings: The results revealed that 53.1% of the women with recent birth utilized ANC in PHCs. Predictive factors for early ANC visits in PHCs were employment status of women [aOR: 19.15, ρ =0.04], prior experience with pregnancy-related complications [aOR: 638.95, ρ = 0.00], walking for at least 60 minutes to the nearest health center [aOR: 0.11, ρ = 0.02] and at least five births [aOR: 8.35, ρ = 0.04]. Predictive factors for a minimum of four ANC visits in PHCs were walking for at least 60 minutes to the nearest health center [aOR: 0.001, ρ = 0.00], rating quality of care in the nearest health center as good [aOR: 26.78, ρ = 0.00] and excellent [aOR: 1,527.95, ρ = 0.00], and reporting at least secondary educational qualification [aOR: 10.47, ρ = 0.07]. The odds for making early ANC visits [aOR: 0.09, ρ = 0.00] and a minimum of four ANC visits in PHCs [aOR: 0.24, ρ = 0.05] were respectively 91% and 76% significantly less likely for respondents drawn from set of communities without PHCs in reference to those from set of communities with PHCs.
Conclusion: Intervention programmes designed to improve women's access to PHCs should address distance barriers, improve quality of care and expand education opportunities for women in the study area.
Keywords: Predictors, Antenatal care, Utilization, Primary Healthcare Centers, Rural communities, Delta State, Nigeria.
References:
- World Health Organization. Coverage of maternity care. A tabulation of available Information, 3rd edition maternal health, and safe motherhood programme, Division of FamilyHealth, Geneva: WHO; 1993. Available at www.who.int/iris/handle/10665/63878. [Accessed on the 18thof August 2018].
- Thaddeus S, Maine, D. Too far to walk: maternal mortality in context, Social Science andMedicine 1994; 38(8):1091-1110.
- Lincetto O, Mothebesoane-anoh S, Gomez P, Munjaja S. Antenatal care: opportunities for Africa's newborns. New York, NY: World Health Organization; 2010. Available athttp://www.who.int/pmchmedia/publications/connection III[Accessed on the 11th of September, 2015].
- World Bank. World development indicators: GNI per capita, PPP;2013(b). Available at http://data.Worldbank.org/indicators/NY.GNP.PCAP.PP.CD [Accessed on the 6th of May, 2017].
- World Health Organization: Making pregnancy safer, the critical role of skilled attendants a joint statement by WHO, ICM, and FIGO. Geneva: WHO; 2004. Available at www.who.int-pregnancy safer/documents/9241891692 [Accessed on the 15th of June, 2017].
- Fagbamigbe, AF, Idemudia, ES. Wealth and antenatal care utilization in Nigeria: policy implications. Health care for Women International. 2017 38:1, 17-37, Doi:10.1080/07399332.2016.1225743
- National Population Commission, ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: National Population Commission, Nigeria, and ICF International; 2014.
- World Health Organization. Maternal Mortality, Geneva: WHO; 2004 Available at www.who.int/reproductivehealth/publications/monitoring/maternal-mortality [Accessed on the 6th of January, 2017].
- Dairu T, Oche OM. Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria. Pan Africa Medical Journal.2015; 22(1).
- Desalew Z A, Bekele B, Kedir T, Desalegn, AA. Factors affecting utilization of maternal Healthcare in Kombolcha District Eastern Harareghe Zone, Ororoma Regional State,Eastern Ethiopia. International Scholarly Research Notices. 2014(2014), Doi.org/10.1155/2014/917058
- Babalola S, Fatusi AO. Determinants of use of maternal health services in Nigeria- looking beyond individual and household factors. BMC Pregnancy and Child Birth.2009; 9,43, Doi:org/10.1186/14718- 23938- 98- 43.
- Okonofua F, Ntoimo L, Ogungbangbe J, Anjorin S, Imongan W, Yaya S. Predictors of women's utilization of primary health care for skilled pregnancy care in rural Nigeria. BMC pregnancy and childbirth. 2018;18(1):106.
- Chakraborty N, Islam MA, Chowdhury, RI, Akhter, NN. Determinants of the Use of maternal health services in rural Bangladesh: Health promotion International.2003; 18(4):327-337.
- Etukudo IW, Inyang, AA. Determinants of use of maternal health care services in a rural Nigerian community. Research on Humanities and Social Sciences. 2014; 4(18), 55-60.
- Oko-Offoboche C. The politics of Maternal Mortality and Morbidity: Examining women's Human Rights and Reproductive wrongs. Multi-disciplinary Journal of Research and Development Perspectives. 2014; 3(2), 59- 71
- Mojekwu J, Ibekwe N. Maternal mortality in Nigeria: Examination of intervention methods. International Journal of Humanities and Social Science.2012; 2(20), 135-149.
- Yaya S, Okonofua FE, Ntoimo L, Kadio B, Deuboue, Imongan W, Balami W.Increasing Women's access to skilled pregnancy care to reduce maternal and perinatal mortality in rural Edo state, Nigeria: a randomized controlled trial.Global Health Research and Policy.2018; 3:12.doi.org/10.1186/s41256-018-0066-y.
- World Health Organization: World Health Report. WHO Geneva; 2000. , available at Who .int/whr/2000/en/[Accessed on the 21st May, 2018].
- Al-Nahedh NNA (1995), Factors affecting the choice of maternal and child health services in the rural areas of Saudi Arabia. Eastern Mediterranean Health Journal. 1995;1(2), 261-269.
- Lucas, AO, Gilles HH. Short Textbook of Public Health Medicine for the Tropics, London, Book power; 2003.
- Arthur. Wealth and antenatal care use: implications for maternal health care utilization in Ghana. Health Economics Review, 2012; 2(14): 1-18,Doi:org/10.1186/2191-1991-2-14.
- World Health Organization: Antenatal care Department of Technical working Group 1994 WHO/Frit/msm/968:1999
- Villar J, Baaqeel, H, Piaggio G, Lumbiganon P, Miguel Belizan J, Farnot U. et al. WHO ANC randomized trial for evaluation of a new model of routine ANC. Lancet. 2001; 357,1551-1564.
- Azuh DE, Azuh AE, Iweala EJ, Adeloye D, Akanbi M, Mordi CR. Factors influencing maternal mortality among rural communities in southwestern Nigeria, International Journal of Women's Health. 2017(9):179-187.
- Okonofua, FE. Increasing life expectancy through improved maternal and child health programming in Nigeria Paper presented at the breakfast meeting with Mr. President Chief Olusegun Obasanjo GCFR at Aso Rock Villa, Abuja organized.
- Ejembi C, Alti-Muazu M, Chirdan O, Ezeh H, Sheidu S, Dahiru T. Utilization of maternal health services by rural Hausa women in Zaria environs, northern Nigeria: has primary health care made a difference? J Community Med Prim Health Care. 2004;16:47-54
- Egbewale B, Odu O. Perception and Utilization of Primary Health Care Services in a Semi-Urban Community in South-Western Nigeria. J Community Med Prim Health Care. 2013; 24:11-20.
- Andersen RM, Newman JF. Social and Individual determinants of medicine utilization in the United States. Milbank Memorial Quarterly.1973; 51(1), 95-124.
- Babitsch B, Gohl D, von Lengerke T. Re-visiting Andersen's Behavioral Model of Health Services Use: a systematic review of studies from 1998-2011. GMS Psycho-Soc-Med. 2012;9.
- Gabrysch S, Campbell OM. Still too far to walk: Literature review of the determinants of delivery service use. BMC Pregnancy and Childbirth.2009; 9, 34 -51
- Alenoghena IO, Isah EC, Isara AR. Maternal health services uptake and its determinants in public primary health care facilities in Edo State, Nigeria. The Nigerian postgraduate medical journal. 2015;22(1):25-31.
- Cochrane, W.G. (1977). Sampling techniques (3rd edition), New York: John Wiley and Sons
- Yaya S, Okonofua FE, Ntoimo L, Kadio B, Deuboue, Imongan W, Balami Increasing Women's access to skilled pregnancy care to reduce maternal and perinatal mortality in rural Edo state, Nigeria: a randomized controlled trial.Global Health Research and Policy.2018; 3:12.doi.org/10.1186/s41256-018-0066-y
- Ajayi IO, Osakinle DC: Socio-demographic factors determining the adequacy of Antenatal care among women visiting Ekiti State Primary Health Care Centers. 2013; OJHAS 12 (2).
- Fagbamigbe AF, Idemudia ES. Barriers to antenatal care use in Nigeria: evidence from non-users and implications for maternal health programming. BMC Pregnancy Childbirth. 2015; 15.
- Gage AJ. Barriers to the Utilization of maternal health care in rural Mali. Social Science andMedicine.2007; 65(8), 1666- 82.
- Ortiz, A. V. (2007). Determinants of demand for antenatal care in Colombia. Health Policy, 86, 363-372.
- Chandhiok, N., Dhillon, S. B., Kambo, I., & Saxena, C. N. (2006). Determinants of antenatal care utilization in rural areas of India: A cross-sectional study from 28 districts. The Journal of Obstetricsand Gynecology of India,56(1), 47-52
- Wilunda, C; Quagho, G; Putoto, G; Risa, T; Federico, C; Abebe, D; Manenti, F et al(2015): Determinants of Utilization of antenatal care and skilled birth attendant in South WestShoa Zone, Ethiopia: a cross-sectional study. Reproductive Health (2015); 12:74.
- Fikre AA, Demissie M. Prevalence of institutional delivery and associated factors in Dadota Woreda(district), Oromia regional state, Ethiopia.Reproductive Health.2012;9:33 doi.10.1186/1742-4755.9.33
- Tsegay Y, Gebrehiwot T, Goicolea I, Edin K, Lemma H, Sebastian MS. Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: a cross-sectional study. Int J Equity Health. 2013;12:30.doi:10.1186/1475-9276-12-30.
- Bohren MA, Hunter EC, Munthe-Kaas HM, Souza JP, Vogel JP, GulmezogluAM. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health.2014;11(1):71. DOI:10.1186/1742-4755-11-71
- Fawole OI, Adeoye IA. Women's status within the household as determinants of maternal health care use in Nigeria. African Health Sciences.2015; 15(1):217-225.
- Singh K, Bloom S, Haney E, Olurunsanye C, Brodish P. Gender Equality and Childbirth in a health facility: Nigeria and MDG5. Afri J Reprod Health .2012; 16(3):123-129.
- Yaya S, Okonofua FE, Ntoimo L, Udenige O, Bishwajit G. Gender Inequality as a barrier to women's access to skilled pregnancy care in rural Nigeria: a qualitative study. International Health, 2019; ihz019,https://doi.org/10.1093/ in health/ ihz2019.
DOI: doi.org/10.35202/AJHE.2019.810122
DOI URL: http://doi.org/10.35202/AJHE.2019.810122
|