Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria

Ajibola Idowu, Oluwaseyi Kikelomo Israel, Roseline Oluyemisi Akande


Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential statistics were done at p<0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents’ age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women. (Afr J Reprod Health 2022; 26[12]: 78-89).

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Asseffa NA, Bukola F and Ayodele A. Determinants of use

of health facility for childbirth in rural Hadiya zone,

Southern Ethiopia. BMC Pregnancy Childbirth.


Tafere TE, Afework MF and Yalew AW. Antenatal care

service quality increases the odds of utilizing

institutional delivery in Bahir Dar city

administration, North Western Ethiopia: A

prospective follow up study. PLoS One.


UNICEF. Maternal mortality rates and statistics - UNICEF

DATA. [cited 2022 Oct 15]. Available from:

National Population Commission, Abuja, Nigeria and ICF

Rockville MU. The Federal Republic of Nigeria

Nigeria Demographic and Health Survey 2018

National Population Commission Abuja, Nigeria.

UNICEF. Situation of women and children in Nigeria |

UNICEF Nigeria. [cited 2020 Jan 27]. Available


Emiru AA, Alene GD and Debelew GT. Women’s

satisfaction with the quality of antenatal care services

rendered at public health facilities in Northwest

Ethiopia: The application of partial proportional odds

model. BMJ Open. 2020;10(9):1–11.

Downe S, Finlayson K, Tunçalp and Metin Gülmezoglu A.

What matters to women: A systematic scoping

review to identify the processes and outcomes of

antenatal care provision that are important to healthy

pregnant women. BJOG An Int J Obstet Gynaecol.


Afulani PA, Buback L, Essandoh F, Kinyua J, Kirumbi and

Cohen CR. Quality of antenatal care and associated

factors in a rural county in Kenya: An assessment of

service provision and experience dimensions. BMC

Health Serv Res. 2019;19(1):1–16.

World Health Organization. WHO Recommendation on

Antenatal Care for a Positive Pregnancy Experience:

Summary. Lancet. 2018;387(10017):1–10.

Berehe TT and Modibia LM. Assessment of Quality of

Antenatal Care Services and Its Determinant Factors

in Public Health Facilities of Hossana Town, Hadiya

Zone, Southern Ethiopia: A Longitudinal Study. Adv

Public Heal. 2020;

Duru CB , Eke NO , Ifeadike CO and Diwe KC. Antenatal

Care Services Utilization among Women of

Reproductive Age in Urban and Rural Communities

of South East Nigeria : A Comparative Study.

AFRIMEDIC J. 2014;Volume 5(No. 1):1–9.

Tran TK, Nguyen CTK, Nguyen HD, Eriksson B, Bondjers

G, Gottvall K, Asder H and Petzold M. Urban - Rural

disparities in antenatal care utilization: A study of

two cohorts of pregnant women in Vietnam. BMC

Health Serv Res. 2011;11:1–9.

Lire T, Megerssa B, Asefa Y and Hirigo AT. Antenatal

care service satisfaction and its associated factors

among pregnant women in public health centres in

Hawassa city, Southern Ethiopia. Proc Singapore

Healthc. 2021;31:1–8.

Mutaganzwa C, Wibecan L, Iyer HS, Nahimana E, Manzi

A, Biziyaremye F, Nyishime M, Nkikabahizi F and

Hirschorn L. Advancing the health of women and

newborns: Predictors of patient satisfaction among

women attending antenatal and maternity care in

rural Rwanda. Int J Qual Heal Care.


Adewuyi EO, Auta A, Khanal V, Bamidele OD, Akuoko CP, Adefemi K, Tapshak SJ and Zhao Y. Prevalence

and factors associated with underutilization of

antenatal care services in Nigeria: A comparative

study of rural and urban residences based on the 2013

Nigeria demographic and health survey. PLoS One.


Adhikari T, Sahu D, Nair S, Saha KB, Sharma RK and

Pandey A. Factors associated with utilization of

antenatal care services among tribal women: A study

of selected states. Indian J Med Res. 2016;144:58–

Population Stat. Oshogbo, Nigeria Population (2022) -

Population Stat. [cited 2022 Oct 3]. Available from:

Oyedeji, G.A. Socio-economic and cultural background of

hospitalized children in Ilesha. Nigerian Journal of

Paediatrics. 1985; 12: 111-117.

Okonofua F, Ntoimo L, Ogungbangbe J, Anjorin S,

Imongan W and Yaya S. Predictors of women ’ s

utilization of primary health care for skilled

pregnancy care in rural Nigeria. 2018;1–15.

Sui Y, Ahuru RR, Huang K, Anser MK and Osabohien R.

Household Socioeconomic Status and Antenatal

Care Utilization Among Women in the

Reproductive-Age. Front Public Heal. 2021;9:1224.

Shambe IH,Pan VC,Enokela MA,Oyebode TA, Daru PH,

Gyang MD and Gyang BZ. Choice of place of

antenatal care among women of reproductive age in

a semiurban population in northcentral Nigeria. Trop

J Obstet Gynaecol. 2018;35(1):54.

DOI: 10.4103/TJOG.TJOG_62_17

Oleribe OO, Udofia D, Oladipo O, Ishola TA and TaylorRobinson SD. Healthcare workers’ industrial action

in Nigeria: A cross-sectional survey of Nigerian

physicians. Hum Resour Health. 2018 Oct



Adeloye D, David RA, Olaogun AA, Auta A, Adesokan A,

Gadanya M, Opele JK, Owagbemi O and

Iseolorunkanmi A. Health workforce and

governance: The crisis in Nigeria. Hum Resour

Health. 2017;15(1):32.

Oguntunde O, Yusuf FM, Nyenwa J, Dauda DS, Salihu A

and Sinai I. Emergency transport for obstetric

emergencies: integrating community-level demand

creation activities for improved access to maternal,

newborn, and child health services in northern

Nigeria. Int J Womens Health. 2018;Volume


Adow I, Mwanzo I, Agina O, Wanzala P and Kariuki J.

Uptake of antenatal care services among women of

reproductive age in Mandera County, Kenya. Afr J

Health Sci. 2020;33(1):56–69.

Haji OA, Suleiman MA and Juma JN. Factors influencing

the uptake of antenatal care services among pregnant

women in South Gaalkacyo district, Mudug region,

Somalia. Int J Community Med Public Heal.



George LU, Oku AO, Asibong IU, Ibitham DA and Idem

NI. Client satisfaction with antenatal care among

clinic attendees in a tertiary health institution in

Calabar, Cross River State, Nigeria. Afr J Reprod

Health. 2022;26(8):20–9.

Obionu CN. Primary Healthcare for Developing

Countries.3rd edition.134 Zik Avenue,Uwane,

Enugu. Ezu Books Ltd.2016:p41

Agaba P, Magadi M, Onukwugha F and Misinde C. Factors

associated with the timing and number of antenatal

care visits among unmarried compared to married

youth in uganda between 2006 and 2016. Soc Sci.


El-Khatib Z, Odusina EK, Ghose B and Yaya S. Patterns

and predictors of insufficient antenatal care

utilization in Nigeria over a decade: A pooled data

analysis using demographic and health surveys. Int J

Environ Res Public Health. 2020 Nov 1;17(21):1–14.

Ali N, Sultana M, Sheikh N, Akram R, Mahumud RA,

Asaduzzaman M and Shaker AR. Predictors of

Optimal Antenatal Care Service Utilization Among

Adolescents and Adult Women in Bangladesh. Heal

Serv Res Manag Epidemiol. 2018.

doi: 10.1177/2333392818781729


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