Determinants of Maternal Utilization of Health Services and Nutritional Status in a Rural Community in South-West Nigeria

Adebowale Ayo Stephen, Akinyemi Odunayo Joshua


Poor Maternal Health (MH) remains an issue of public health concern in Nigeria. This study identified the determinants of maternal utilization of health services and nutritional status in a rural community in south-west Nigeria. It was a cross-sectional house-hold survey of women aged 15-49 years. Data were analysed using Chi-square, logistic regression and generalized linear models (α=.05). Respondents’ mean age was 29.9±7.8 years and about 9.0% were underweight, 76.7% attended ≥4 ANC visits and 65.7% were provided with ANC by skilled health workers. Sixty-two percent delivered in modern health facility, 67.5% were assisted by skilled health worker and 29.1% sought post-natal care within the first 3 days after delivery. The likelihood of delivery in health facility was 1.48(C.I=1.10-1.99, p<0.05) higher among women in monogamous than those in polygamy family. The estimated maternal mortality ratio was 448 deaths/100,000 live-births. The findings emphasize the need to scale-up MH improvement strategies in the study area. (Afr J Reprod Health 2016; 20[2]: 72-85).

Full Text:



Population Reference Bureau. World Population Datasheet 2013. 2. Akpomuvie OB. Poverty, Access to Health Care Services and Human Capital Development in Nigeria. An International Multi-Disciplinary Journal, Ethiopia. 2010; 4(3a):41-55. 3. Ahmed H. Effects of poverty on child health and paediatric practice in Nigeria: An overview. Ann Afr Med 2007;6:142-56. Available from: http://www .annalsafrmed. org/ text.asp?2007/6 4. Nnebue CC, Ebenebe UE, Adogu PO, Adinma ED, Ifeadike CO, Nwabueze AS. Adequacy of resources for provision of maternal health services at the primary health care level in Nnewi, Nigeria. Niger Med J. 2014;55(1):235-41 5. Osibogun A. Crises and Challenges in the Nigerian Health Sector. Journal of Community Medicine and Primary Health Care. 2004;16(2):1-7 6. National Population Commission. National policy on population for sustainable development. Abuja, Nigeria: National Population Commission 2004. 7. Mosley WH, Chen LC. An analytic framework for the study of child survival in developing countries. Population and Development Review,1984;10,25-45. 8. Galaa SZ, Daare K. Understanding barriers to maternal child health services utilisation in northern Ghana. Journal of Social Development in Africa, 2008;23(2) 9. Magadi M. Maternal and Child Health among the Urban Poor in Nairobi, Kenya. African Population Studies/Etude de la Population Africaine, 2004;19(2), 179-198. 10. Hans Wessel , Pitt Reitmaier, Alice Dupret, ErnestoRocha, Sven Cnattingius, Staffan Bergström. ‘Deaths among Women of Reproductive Age in Cape Verde: Causes and avoidability’, Acta Obstetricia et Gynecologica Scandinavica, 1999;78(3):225–232. 11. Bartlett LA, Mawji S, Whitehead S, Crouse C, Dalil S, Ionete D, Salama P. ‘Where Giving Birth is a Forecast of Death: Maternal mortality in four districts of Afghanistan, 1999–2002’, The Lancet, 2005;365(9462):864-870. 12. Onasoga AO, Osaji TA, Alade OA and Egbuniwe MC. Awareness and barriers to utilization of maternal health care services among reproductive women in

Adebowale & Akinyemi Maternal Health Assessment

African Journal of Reproductive Health June 2016; 20 (2): 85

Amassoma community, Bayelsa State. International Journal of Nursing and Midwifery. 2014;6(1):10-15 13. Etukudo IW, Inyang AA. Determinants of use of Maternal Health Care Services in a Rural Nigerian Community. Research on Humanities and Social Sciences. 2014;4(18):55-60. 14. Beeckman K, Louckx F and Putman K. Determinants of the number of antenatal visits in a metropolitan region. BMC Public Health 2010, 10:527 doi:10.1186/1471-2458-10-527. 15. Babalola S, Adesegun F. Determinants of use of maternal health services in Nigeria - looking beyond individual and household factors. BMC Pregnancy and Childbirth 2009; 9:43. doi:10.1186/1471-23939-43. 16. United Nations Millennium Development Goals website, retrieved 21 September 2013. http://www. 17. Iyaniwura CA, Yussuf Q. Utilization of antenatal care and delivery services in Sagamu, south western Nigeria. Afr J Reprod Health. 2009;13(3):111-22. 18. United Nations. Manual X: Indirect Method for Demographic Estimations. Department of International Economic and Social Affairs, New York: United Nations. Population Studies, No. 81. 1983. 19. Graham W, Brass W, Snow R. Estimating Maternal Mortality in Developing countries. The lancet, 1988; 1(8582):416-7. 8. 20. WHO. World Health Statistics 2014. Geneva, World Health Organization 2014. 21. UNICEF. The Inter-agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality. Report 2013. New York, USA, UNICEF. 22. Rehana Rahim, Tanveer Shafqat & Nasreen Ruby Faiz. An analysis of direct causes of maternal mortality. JPMI 2006; 20(1):86-91. 23. National Population Commission and ICF Macro. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro. 2009. 24. National Population Commission and ICF Macro. Nigeria Demographic and Health Survey 2003. Abuja, Nigeria: National Population Commission and ICF Macro. 2004.

Adebowale SA, Adepoju OT & Fagbamigbe FA. Child Spacing and Parity Progression: Implication for Maternal Nutritional Status among Women in Ekiti Communities, Southwestern Nigeria. Pakistan Journal of Nutrition 2011; 10 (5): 485-491. 26. Akinyele IO. Ensuring Food and Nutrition Security in Rural Nigeria. An assessment of the challenges, information needs, and analytical capacity. International food policy research institute 2010. 27. Morgenstern M, Sargent JD & Hanewinkel R. Relation between socioeconomic status and body mass index: evidence of an indirect path via television use. Arch Pediatr Adolesc Med 2009; 163(8):731-8. 28. Maximilian D. Schmeiser. The Impact of Family Income on the BMI of Women and Men Eligible for the Earned Income Tax Credit. Institute for Research on Poverty. Discussion Paper no. 1339-08, 2008. 29. WHO. Global Health Observatory. World Health Organization bulletin 2010. 30. Dairo, M.D; Owoyokun, K.E. 2010. Factors affecting the utilization of antenatal care services in Ibadan, Nigeria. Benin Journal of Postgraduate Medicine. Vol. 12(1):3-13 31. FA Akanbiemu, A Manuwa-Olumide, AF Fagbamigbe and AS Adebowale. (2013). Effect of Perception and Free Maternal Health Services on Antenatal Care Facilities Utilization in Selected Rural and SemiUrban Communities of Ondo State, Nigeria. British Journal of Medicine & Medical Research 3(3): 681697, 2013 SCIENCE DOMAIN international. 32. The partnership for maternal, newborn and child health. Newborn death and illness.http://www. pmnchedia/press_materials/fs/fs_newborndealth _illness/en/:Accessed 25th November, 2015. 33. Federal Ministry of Health. Revised National Health Policy. Abuja. Nigeria: Federal Ministry of Health 2004. 34. Maternal Mortality Estimates developed by WHO, UNICEF and UNFPA. Geneva, WHO, 2004. http:// mortality/en/. 35. Adebowale SA, Fagbamigbe FA, Bamgboye EA. Rural- Urban Differential in Maternal Mortality Estimate in Nigeria, sub-Saharan Africa. Journal of Medical and Applied Biosciences2010;2(1):74-91.


  • There are currently no refbacks.