ABSTRACT
Background: Health services rendered to pregnant women is important for promoting the overall health status of mother and child. The well-being of mothers serves as a vital measure of healthcare quality within any nation. There is therefore the need for improvement in quality and utilization of antenatal care service, especially in PHCs which serve as the first entry point into the health system. Objective: The objective of this study was to assess antenatal care services, its utilization, determinants, and challenges with its utilization, in Primary Health Care Centres in Egor LGA. Methods: The study was a cross-sectional community-based study conducted in Egor LGA of Edo State, Nigeria. A total of 6 PHCs in Egor LGA were assessed using an observational checklist, and a total of 412 randomly selected women of reproductive age were interviewed in their households using a pre-tested structured questionnaire. The data were analyzed with descriptive and multivariate statistical methods. p value was set at <0.05. Results: The results showed that 4 (66.7%) of the PHCs assessed had good quality, while perceived good quality among respondents was 18 (81.8%). Level of ANC utilization in PHCs was low, as 22 (5.4%) of the respondents utilized ANC in PHCs while other respondents used other facilities for ANC. Inadequate utilization was reported by 404 (98.1%) of respondents, as only 176 (43.1%) initiated ANC within the first 3 months, and 269 (65.9%) of respondents had at least 8 ANC visits, but in PHCs. Chi-square test of association revealed that household monthly income, awareness of PHC in the community, and distance to nearest PHC were significantly related to use of PHCs for antenatal care. The results of logistic regression for antenatal care utilization in PHCs showed that women with household monthly income of greater than 40,000 xiv naira, were less likely to utilize ANC in PHC (OR 0.080, CI 0.012 - 0.527). p value was set at <0.05 Conclusion/ Recommendation: The quality of ANC in PHCs was good. The level and adequacy of utilization of PHCs for ANC was however low as respondents reported late initiation of ANC visits although many had the minimum required number of ANC visits according to WHO guidelines for ANC. Factors which were found to be significant determinants of the utilization of ANC in PHCs were household monthly income and level of awareness of PHC in community. Major challenges encountered by women who utilized ANC services in PHCs were bad road and short opening/working hours of PHCs. Efforts geared towards addressing the poor utilization of ANC in PHCs is multi factorial and should be implemented by all relevant stakeholders to ensure successful pregnancy outcomes of mother and child. Keywords: Assessment, Antenatal care, Primary health centres, women of reproductive age, Egor LGA, quality, utilization Edo State, Nigeria.
