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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Predictors of women’s utilization of primary health care for skilled pregnancy care in rural Nigeria

Authors: Friday Okonofua, Lorretta Ntoimo, Julius Ogungbangbe, Seun Anjorin, Wilson Imongan, Sanni Yaya

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

Although Primary Health Care (PHC) was designed to provide universal access to skilled pregnancy care for the prevention of maternal deaths, very little is known of the factors that predict the use of PHC for skilled maternity care in rural parts of Nigeria - where its use is likely to have a greater positive impact on maternal health care. The objective of this study was to identify the factors that lead pregnant women to use or not use existing primary health care facilities for antenatal and delivery care.

Methods

The study was a cross-sectional community-based study conducted in Esan South East and Etsako East LGAs of Edo State, Nigeria. A total of 1408 randomly selected women of reproductive age were interviewed in their households using a pre-tested structured questionnaire. The data were analyzed with descriptive and multivariate statistical methods.

Results

The results showed antenatal care attendance rate by currently pregnant women of 62.1%, and a skilled delivery of 46.6% by recently delivered women at PHCs, while 25% of women delivered at home or with traditional birth attendants. Reasons for use and non-use of PHCs for antenatal and delivery care given by women were related to perceptions about long distances to PHCs, high costs of services and poor quality of PHC service delivery. Chi-square test of association revealed that level of education and marital status were significantly related to use of PHCs for antenatal care. The results of logistic regression for delivery care showed that women with primary (OR 3.10, CI 1.16–8.28) and secondary (OR 2.37, CI 1.19–4.71) levels education were more likely to receive delivery care in PHCs than the highly educated. Being a Muslim (OR 1.56, CI 1.00–2.42), having a partner who is employed in Estako East (OR 2.78, CI 1.04–7.44) and having more than five children in Esan South East (OR 2.00, CI 1.19–3.35) significantly increased the odds of delivery in PHCs. The likelihood of using a PHC facility was less for women who had more autonomy (OR 0.75, CI 0.57–0.99) as compared to women with higher autonomy.

Conclusion

We conclude that efforts devoted to addressing the limiting factors (distance, costs and quality of care) using creative and innovative approaches will increase the utilization of skilled pregnancy care in PHCs and reduce maternal mortality in rural Nigeria.
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Metadata
Title
Predictors of women’s utilization of primary health care for skilled pregnancy care in rural Nigeria
Authors
Friday Okonofua
Lorretta Ntoimo
Julius Ogungbangbe
Seun Anjorin
Wilson Imongan
Sanni Yaya
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1730-4

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