Antenatal care utilisation in Nigeria: assessing disparities between rural and urban areas—analysis of the 2018 Nigeria demographic and health survey

Abstract

Abstract Objectives This study presents a comprehensive assessment of antenatal care (ANC) utilisation in Nigeria, focusing on the disparities between rural and urban areas. Methods We used the data disaggregation approach to analyse the 2018 Nigeria Demographic and Health Survey. We estimated ANC utilisation, assessed the receipt of ANC components, and identified factors associated with eight or more (≥ 8) ANC contacts nationally and across rural and urban residences. Results The overall ≥ 8 ANC utilisation was 20.3% in Nigeria—35.5% in urban and 10.4% in rural areas. Nationally and in urban areas, the North-East region had the lowest ANC use at 3.7% and 3.0%, respectively, while the North-West had the lowest in rural areas (2.7%). Nationally, 69% of mothers received iron supplements, 70% had tetanus injections, and 16% received drugs for intestinal parasites, with urban residents having higher percentages across all ANC components. Maternal and husband education, health insurance, and maternal autonomy were common factors associated with increased ANC odds at the national, rural, and urban residences. All ethnic groups had higher ANC odds than the Hausa/Fulanis in urban areas, while only the Yorubas had greater odds in rural areas. Internet use was significant only in the national context, watching television only in urban settings, while maternal working status, wealth, birth type, religion, and listening to the radio were significant only in rural areas. Conclusion Our study highlights considerable disparities in ANC utilisation and quality with a greater vulnerability for rural residents, rural northern regions, and socioeconomically disadvantaged mothers. Targeted interventions are imperative to address the disparities and improve ANC use in Nigeria, with priority for the most vulnerable sub-populations.