Factors associated with utilization of focused antenatal care (FANC) services in Nigeria: 2013 -2018

BACKGROUND: The global burden of maternal mortality is high, hence measures such as focused antenatal care (FANC) has been put in place to reduce pregnancy-related deaths. However, attendance of FANC is low in many sub-Saharan African countries, including Nigeria. Many women in Nigeria fail to attend the minimal number of contacts with health professionals. However, the factors associated with utilization of FANC services are yet to be clearly understood. Thus, the objective of this study was to examine trends in the use of FANC services and the factors associated with its use among women in Nigeria. DATA AND METHODS: The 2013 and 2018 dataset of the Nigerian Demographic and Health Survey was analysed in this study. Univariate, bivariate, and multivariate analysis were conducted. RESULTS: The study found that between 2013 and 2018, the number of women receiving FANC increased by more than 5%, from 51.5% to 56.8%. Furthermore, the results showed that, in both surveys, attainment of post-primary level of education, residing in urban areas, living in a wealthy household, and residing in the Southern region of the country were significantly associated with utilization of FANC. However, household wealth and women's level of education were the greatest predictors of FANC utilization in both surveys. CONCLUSIONS: Policy intervention aimed at addressing women with low antenatal care attendance is critical in improving maternal health in Nigeria. It is also important for government at all levels to implement policies that ameliorate the economic conditions of women, promote education of girls and women, improve healthcare delivery in rural settings, improve the number of antenatal care facilities and ensure equitable distribution of FANC facilities and providers across the various regions and places of residence in the country. KEY MESSAGES: • Focused antenatal care has the potential of improving pregnancy-related outcome because it enables health professionals to detect and manage abnormalities. However, attendance is low in Nigeria. • Using a nationally representative dataset, the study explored the factors associated with focused antenatal care. The result showed that socio-economic characteristics are crucial to use or non-use.