Timing and utilisation of antenatal care service in Nigeria and Malawi

ABSTRACT

As the world draws curtains on the implementation of Millennium Development Goals (MDGs), there is increasing interest in evaluating the performance of countries on the goals and assessing related challenges and opportunities to inform the upcoming Sustainable Development Goals (SDGs). This study examined changes in the timing and utilisation of maternal health care services in Nigeria and Malawi; using multivariate negative log–log and logistic regression models fitted to demographic and health survey data sets. Predicted probabilities were also computed to observe the net differences in the likelihood of both the first and the required number of antenatal care (ANC) visits for each of the three analysis years. Women in Nigeria were 7% less likely in 2008 compared to 2003, and in Malawi, 32% more likely in 2013 compared to 2000, to utilise ANC in the first trimester of pregnancy. Timing of first ANC visit was strongly influenced by wealth in Nigeria but not in Malawi. The findings in our case studies show how various contextual factors may enable or inhibit policy performance. Maternal and child health, SDGs should incorporate both wealth and degrees of urbanicity into country level implementation strategies.

KEYWORDS:

• Maternal health
• antenatal care
• sub-Saharan Africa
• MDGs
• post-2015
• residential wealth index

Acknowledgements

The authors thank the Demographic and Health Surveys (DHS) Program for the access to the data used in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Vincent Z. Kuuire http://orcid.org/0000-0003-2782-3915

Kilian N. Atuoye http://orcid.org/0000-0002-6003-980X

Roger Antabe http://orcid.org/0000-0003-0312-3201

Isaac Luginaah http://orcid.org/0000-0001-7858-3048

Additional information

Funding

The authors thank the funders of the DHS surveys in Nigeria and Malawi – the United States Agency for International Development (USAID) and the Government of Malawi and Nigerian Government.