Determinants Of Antenatal Health Care Utilization Among Women In Nigeria.

ABSTRACT

World health organization estimates that more than half a million women lose their lives in the process of reproduction worldwide every year and most of these mortalities are avoidable if mothers have access to antenatal care services {Zelalem 2000}. Improved maternal and neonatal outcomes have been associated with utilization of antenatal care services (MHCS) (Navaneetham & Dharmalingam, 2000; Mekonnen & Mekonnen, 2002; Babalola & Fatusi, 2009). Globally more than 70% of maternal deaths are due to five major complications (which are directs obstetric complications): hemorrhage (25%), infections (15%), and complications of unsaved abortions (13%), hypertension (12%), and obstructed labor (8%) (Ochako, Christopher, 2003). These complications occur at any time during pregnancy and child birth, often without fore warding and often requiring immediate access to emergency obstetric care for their management. The World Bank estimates that 74% of maternal deaths could be averted if all women had access to interventions that address complications of pregnancy and childbirth, especially emergency obstetric care (Ochako, Christopher 2003). Complications of pregnancy and childbirth are a leading cause of maternal morbidities and mortalities for women of reproductive age (15 – 49 years) in developing countries. The WHO estimates that over 500,000 women and girls die from complications of pregnancy and childbirth each year, worldwide, with approximately 99% of these deaths occurring in developing countries. With a maternal mortality ratio of 545 deaths per 100,000 live births (WHO,2008). In sub-Saharan Africa 95% of maternal deaths occur annually and Asia. Africa has the highest burden of maternal mortality in the world and Sub-Sahara Africa is largely responsible for the maternal death figure for that region, contributing approximately 98% of the maternal deaths for the region (Seifu and meressa 2017). Antenatal care utilization was low (Mekonnen & Mekonnen, 2002; Mpembeni, 2007), including Nigeria (Galadanci, 2007; Babalola & Fatusi, 2009); 51% of women who had live birth, visited antenatal clinics at least four times during their pregnancy,10% of women reported two or three antenatal visits during their last pregnancy, 34% of women did not receive any antenatal care. The results show that only 18% of women had their first antenatal visit in the first trimester of the pregnancy. (NDHS,2013). Sub Saharan Africa has the highest maternal mortality ratio in the world and account for more than half of maternal death worldwide. As the result disparities between developed and developing countries in terms of utilization of antenatal, delivery, and post natal services are unfairly large, in developed countries, it is estimated that about 97% of the pregnant women receive antenatal care and 99% use skilled obstetric service at delivery, whereas in developing countries, only 65% and 53% of women use antenatal care and skilled obstetric care services respectively ( Zelalem, 2014).