Project – Assessment of Maternal Health Service Utilization among Women of Reproductive Age in Ikorodu LGA

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Maternal health remains a critical component of public health, particularly in developing countries where maternal morbidity and mortality rates are still unacceptably high. Maternal health service utilization refers to the use of essential healthcare services by women during pregnancy, childbirth, and the postpartum period. These services include antenatal care (ANC), skilled birth attendance, postnatal care (PNC), and access to emergency obstetric services. The effective utilization of these services plays a significant role in reducing maternal and neonatal deaths and improving overall health outcomes.

Globally, significant progress has been made in reducing maternal mortality, especially under initiatives such as the Sustainable Development Goals (SDGs), which aim to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 (World Health Organization [WHO], 2022). However, sub-Saharan Africa continues to bear a disproportionate burden, accounting for nearly two-thirds of global maternal deaths. Nigeria, in particular, remains one of the countries with the highest maternal mortality rates, with estimates suggesting approximately 512 deaths per 100,000 live births (National Demographic and Health Survey [NDHS], 2018).

Despite the availability of maternal health services in many parts of Nigeria, utilization remains suboptimal due to a range of socio-economic, cultural, and systemic factors. These include low levels of education, poverty, limited awareness, cultural beliefs, distance to health facilities, inadequate healthcare infrastructure, and poor quality of services. In many communities, women still rely on traditional birth attendants or home delivery due to mistrust of formal healthcare systems or financial constraints.

Ikorodu Local Government Area in Lagos State is a rapidly growing semi-urban region characterized by a mix of urban and rural populations. Although Lagos State has relatively better healthcare infrastructure compared to other states in Nigeria, disparities still exist in access to and utilization of maternal health services within its local government areas. Women in Ikorodu may face challenges such as overcrowded health facilities, transportation barriers, indirect costs of care, and sociocultural influences that affect their health-seeking behavior.

Furthermore, maternal health service utilization is influenced by factors such as age, parity, marital status, level of education, occupation, and decision-making autonomy. Studies have shown that women who are more educated and economically empowered are more likely to utilize maternal health services compared to those with limited resources (Adedokun & Uthman, 2019). Additionally, the role of male partners, family support systems, and community norms significantly affects women’s ability to seek and utilize care.

The assessment of maternal health service utilization among women of reproductive age in Ikorodu LGA is therefore essential to identify existing gaps, understand determinants of service use, and provide evidence-based recommendations for improving maternal healthcare delivery. Such an assessment will contribute to policy formulation and program implementation aimed at enhancing maternal health outcomes in the area and beyond.

1.2 Statement of the Problem

Maternal mortality and morbidity remain significant public health challenges in Nigeria despite ongoing efforts by government and international organizations to improve maternal healthcare services. While maternal health services such as antenatal care, skilled delivery, and postnatal care are available in many parts of Lagos State, their utilization among women of reproductive age is still not optimal.

In Ikorodu LGA, anecdotal evidence and previous studies suggest that many women either do not access maternal health services at all or do so inadequately. Some women attend antenatal care irregularly, deliver outside healthcare facilities without skilled birth attendants, or fail to seek postnatal care after childbirth. This inadequate utilization increases the risk of complications such as hemorrhage, infections, eclampsia, and obstructed labor, which can lead to maternal and neonatal deaths.

Several factors contribute to this problem, including financial constraints, lack of awareness, cultural beliefs, poor attitudes of healthcare workers, long waiting times, and inadequate health facilities. Additionally, decision-making power within households often limits women’s ability to seek timely healthcare services. Even in areas where services are physically accessible, perceived poor quality of care discourages utilization.

Despite improvements in healthcare infrastructure in Lagos State, there is limited empirical data specifically focusing on maternal health service utilization in Ikorodu LGA. Without such data, it becomes difficult for policymakers, healthcare providers, and stakeholders to design targeted interventions that address the unique challenges faced by women in this area.

Therefore, this study seeks to assess the level of maternal health service utilization among women of reproductive age in Ikorodu LGA and identify the factors influencing their use of these services. Addressing this gap is crucial for improving maternal health outcomes and achieving national and global health targets.

1.3 Objectives of the Study

The general objective of this study is to assess maternal health service utilization among women of reproductive age in Ikorodu LGA.

The specific objectives are to:

1. Determine the level of antenatal care utilization among women in Ikorodu LGA.
2. Examine the rate of skilled birth attendance during delivery.
3. Assess the level of postnatal care utilization among women.
4. Identify socio-economic and cultural factors influencing maternal health service utilization.
5. Evaluate barriers to accessing maternal health services in Ikorodu LGA.

1.4 Research Questions

1. What is the level of antenatal care utilization among women in Ikorodu LGA?
2. To what extent do women utilize skilled birth attendants during delivery?
3. What is the level of postnatal care utilization among women?
4. What factors influence maternal health service utilization in Ikorodu LGA?
5. What barriers hinder women from accessing maternal health services?

1.5 Research Hypothesis

H₀ (Null Hypothesis):
There is no significant relationship between socio-economic factors and maternal health service utilization among women of reproductive age in Ikorodu LGA.

1.6 Significance of the Study

This study will be beneficial to several stakeholders:

• Government and Policymakers: It will provide evidence for designing policies and programs aimed at improving maternal health service delivery.
• Healthcare Providers: It will help identify gaps in service delivery and improve the quality of care.
• Researchers and Academics: It will contribute to existing literature on maternal health in Nigeria.
• Community Members: It will create awareness about the importance of utilizing maternal health services.

1.7 Scope of the Study

This study focuses on women of reproductive age (15–49 years) residing in Ikorodu Local Government Area of Lagos State. It examines their utilization of antenatal, delivery, and postnatal services, as well as the factors influencing their healthcare-seeking behavior.

1.8 Operational Definition of Terms

• Maternal Health Services: Healthcare services provided to women during pregnancy, childbirth, and after delivery.
• Utilization: The extent to which available health services are used by individuals.
• Antenatal Care (ANC): Medical care received during pregnancy.
• Skilled Birth Attendance: Delivery assisted by trained health professionals such as doctors, nurses, or midwives.
• Postnatal Care (PNC): Care given to the mother and newborn immediately after birth.
• Women of Reproductive Age: Women aged 15–49 years.

Project – Assessment of Maternal Health Service Utilization among Women of Reproductive Age in Ikorodu LGA