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Niger J Med. 2012 Apr-Jun;21(2):196-204.

Proximate determinants of antenatal care utilization among women in southeastern Nigeria.

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Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.



In order to scale up Antenatal services, there is need to determine the factors that deter women from accessing antenatal care.


To determine the proximate factors that affect utilization of antenatal care among market women in Nnewi, southeastern Nigeria.


A cross sectional survey of 400 market women using semi structured questionnaires and focus group discussions.


Out of the 398 studied women, 97.2% attended antenatal care in their last pregnancy. Most (64.5%) of them booked after the third trimester and majority of the women received antenatal care from the private specialist hospitals (37.4%), followed by the private general practice hospitals (34.7%) and government hospitals (17.8%). The main reasons for choosing antenatal care facilities were the perceived friendliness of the staff (33.9%), availability of staff always (27.4%) and proximity of the facility (17.4%). Financial considerations accounted for 4.5% of the reasons for the choice of facility. There was no significant influence of age, parity and religion on the utilization of antenatal care. However, the likelihood of ANC attendance was significantly lower among the house wives (x2 = 14.2; p = 0.0). There was no association between choice of facility for ANC and age, parity, occupation or religion. The main reasons identified by the FGD discussants for preferring the private hospitals were more friendly and available staff. Also late booking was mainly attributed to wrong advice from friends and husbands refusal to provide money. Antenatal care attendance rate was high among the studied women and most of the women utilize private hospitals for care. Staff friendliness and availability at all times were the main reasons for choice of ANC facilities. There is the need to address the negative attitudes of the staff in government hospitals.

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