Utilization of Maternal Health Care Services and Factors Associated with Adequate Antenatal Care among Pregnant Women in Ilorin East Local Government Area, Kwara State, Nigeria

Abstract

Introduction: Maternal mortality in Nigeria represents a high percentage of the total number of maternal deaths worldwide. The attainment of SDG 3.1, which aims to reduce the maternal mortality rate below 70 deaths per 100,000 live births by 2030, remains a critical target. Inequality in MHC utilization is still an issue in Nigeria, and the Kwara State government has prioritized maternal health interventions. Ilorin East LGA, a semi-urban area comprising diverse socio-economic statuses, provides a setting to examine the determinants of MHC utilization.  Aim: The study aims to determine the level of utilization of MHC services and their associated factors among pregnant women in Ilorin East LGA, Kwara State, Nigeria.  Methodology: This is a descriptive cross-sectional survey carried out among 272 pregnant women in Ilorin East LGA, utilizing a multistage sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire and analyzed using SPSS software. Descriptive statistics and Chi-square were employed with a significance level of P < 0.05  Results: The mean age of respondents was 31.8 ± 7.5 years. The majority were aged 26-35 years (55.88%), Yoruba ethnic group (85.66%), Muslim religion (73.16%), married (87.87%), and self-employed (71.32%). Low income was found among more than a third (30.15%) of respondents, and a tertiary education level among only one-fifth (21.69%). In addition, the majority gave birth in health facilities (87.87%), and nearly all followed nurse health education (95.96%). About nine-tenths of the participants indicated that their culture permits MHC use (92.65%), but slightly more than one-tenth prefer TBA (11.40%). Hospital expenses considerations came before MHC use in two-thirds of cases (66.18%). Chi-square test revealed education (χ²=18.67, p<0.001), income (χ²=12.91, p=0.005), and occupation (χ²=9.38, p=0.025) as significant predictors of adequate MHC utilization, but not age and parity.  Conclusion: While there was high utilization of MHC services, sociodemographic factors such as education, income, and occupation significantly affected adequate ANC utilization. Low levels of education, income, and unemployment were negatively related to adequacy of ANCs utilization. Expanding health insurance coverage and subsidizing ANC usage among socioeconomically deprived women are suggested as effective measures in enhancing adequate utilization and achieving SDG 3.1.