Project – Factors Affecting Utilization of Antenatal Care Services among Pregnant Women in Primary Health Centres in Oredo LGA, Edo State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Antenatal care (ANC) is a critical component of maternal healthcare services aimed at ensuring the health and well-being of both the mother and the unborn child during pregnancy. It involves a series of scheduled clinical assessments, health education, screening, and preventive interventions designed to identify and manage potential pregnancy-related complications early. The World Health Organization (WHO) recommends a minimum of eight antenatal contacts to reduce maternal and perinatal mortality and improve pregnancy outcomes (WHO, 2016).

Globally, maternal mortality remains a major public health challenge, particularly in low- and middle-income countries. Many of these deaths are preventable through timely and adequate antenatal care services. Studies have shown that women who attend antenatal care regularly are more likely to deliver in health facilities under skilled birth attendants, thereby reducing risks associated with childbirth complications such as haemorrhage, pre-eclampsia, and infections.

Despite global efforts to improve maternal health outcomes, disparities still exist in the utilization of antenatal care services. In many developing countries, including those in Sub-Saharan Africa, a significant proportion of pregnant women either begin antenatal care late or fail to complete the recommended number of visits. This situation is often attributed to factors such as poverty, low educational attainment, cultural beliefs, distance to health facilities, lack of male partner support, and poor quality of healthcare services.

In Nigeria, maternal mortality remains alarmingly high, with limited progress in reducing preventable deaths. According to national health statistics, a considerable proportion of pregnant women do not fully utilize antenatal care services, which contributes to poor maternal and neonatal outcomes. Although antenatal services are provided through primary healthcare centres across the country, utilization rates vary significantly across regions and communities.

In Edo State, antenatal care services are delivered through public and private health facilities, including primary health centres. However, utilization remains inconsistent, especially in urban and semi-urban areas where socio-economic and cultural factors influence healthcare-seeking behaviour. One of such local government areas is Oredo, which serves as a densely populated urban centre with a mix of formal and informal settlements. Primary health centres in this area are expected to provide accessible maternal healthcare services, including antenatal care, to pregnant women.

Despite the availability of these services, many pregnant women in Oredo LGA either delay booking for antenatal care or do not attend the recommended number of visits. This raises concerns about the factors influencing utilization of antenatal care services in the area. Understanding these factors is essential for improving maternal health outcomes and ensuring effective healthcare delivery at the primary care level.

Therefore, this study seeks to examine the factors affecting utilization of antenatal care services among pregnant women in primary health centres in Oredo Local Government Area, Edo State.

1.2 Statement of the Problem

Antenatal care is essential for monitoring pregnancy, preventing complications, and ensuring safe delivery. However, despite the availability of antenatal care services in primary health centres, many pregnant women in Nigeria still do not fully utilize these services.

In Oredo, primary health centres are strategically located to provide maternal healthcare services, yet utilization of antenatal care remains suboptimal. Reports and observations suggest that a significant number of pregnant women either register late for antenatal care or attend fewer visits than recommended by health authorities.

This situation is concerning because inadequate utilization of antenatal care services increases the risk of pregnancy-related complications, maternal deaths, and poor neonatal outcomes. It also limits the ability of healthcare providers to detect and manage conditions such as anaemia, gestational diabetes, hypertensive disorders, and infections during pregnancy.

Several factors may contribute to low utilization of antenatal care services in the study area. These include financial constraints, long waiting times at health facilities, negative attitudes of healthcare workers, cultural beliefs and practices, lack of awareness of the importance of antenatal care, and inadequate male partner support. However, the extent to which these factors influence antenatal care utilization in Oredo LGA has not been sufficiently studied.

Furthermore, there is limited localized empirical evidence on the specific barriers faced by pregnant women in accessing antenatal care services in primary health centres within the area. Without such evidence, it becomes difficult for health planners and policymakers to design targeted interventions that address the actual needs of pregnant women.

It is against this background that this study investigates the factors affecting utilization of antenatal care services among pregnant women in primary health centres in Oredo Local Government Area, Edo State.

1.3 Objectives of the Study

The main objective of this study is to examine the factors affecting utilization of antenatal care services among pregnant women in primary health centres in Oredo LGA, Edo State.

Specifically, the study aims to:

1. Determine the level of utilization of antenatal care services among pregnant women in Oredo LGA.
2. Identify socio-economic factors influencing antenatal care utilization.
3. Examine cultural and behavioural factors affecting antenatal care attendance.
4. Assess health system factors influencing antenatal care utilization in primary health centres.

1.4 Research Questions

1. What is the level of utilization of antenatal care services among pregnant women in Oredo LGA?
2. What socio-economic factors influence antenatal care utilization?
3. How do cultural and behavioural factors affect antenatal care attendance?
4. What health system factors influence antenatal care utilization in primary health centres?

1.5 Research Hypothesis

H₀: There is no significant relationship between socio-economic factors and utilization of antenatal care services among pregnant women in primary health centres in Oredo Local Government Area.

H₁: There is a significant relationship between socio-economic factors and utilization of antenatal care services among pregnant women in primary health centres in Oredo Local Government Area, Edo State.

1.6 Significance of the Study

This study is significant in several ways. First, it will provide empirical evidence on the factors influencing antenatal care utilization in Oredo LGA, which can guide maternal health planning and intervention strategies. Second, it will assist policymakers and health administrators in identifying barriers to effective antenatal care delivery. Third, healthcare providers will benefit from insights that can improve service quality and patient engagement. Finally, the study will contribute to academic literature on maternal health and healthcare utilization in Nigeria.

1.7 Scope of the Study

This study is limited to pregnant women attending primary health centres in Oredo Local Government Area, Edo State. It focuses on factors affecting antenatal care utilization, including socio-economic, cultural, behavioural, and health system-related factors.

1.8 Operational Definition of Terms

Antenatal Care (ANC): Medical care and monitoring provided to pregnant women to ensure a healthy pregnancy and safe delivery.

Utilization: The extent to which pregnant women make use of antenatal care services as recommended.

Primary Health Centre: A community-based health facility that provides basic maternal, child, and general healthcare services.

Socio-economic Factors: Conditions such as income, education, occupation, and financial status that influence healthcare access.

Cultural Factors: Beliefs, traditions, and practices that affect health-seeking behaviour during pregnancy.

Project – Factors Affecting Utilization of Antenatal Care Services among Pregnant Women in Primary Health Centres in Oredo LGA, Edo State