PERCEPTIONS, EXPERIENCES AND FACTORS AFFECTING MATERNAL HEALTH SERVICE UTILISATION IN NIGERIA
Abstract
Nigeria continues to face a critical maternal health crisis, contributing disproportionately to
global maternal mortality despite representing only 2% of the world’s population. With a
maternal mortality ratio (MMR) of 1,047 deaths per 100,000 live births in 2020 and an
estimated 82,000 maternal deaths, Nigeria alone accounted for 29% of global maternal deaths
in 2023 (WHO, 2023). While antenatal care (ANC) coverage has improved over the decades,
utilisation remains inconsistent and inequitable, with rural, poor, and less educated women
disproportionately excluded from life-saving services. Barriers such as delays in seeking,
reaching, and receiving skilled care, coupled with shortages of health workers, weak
infrastructure, hidden costs, and entrenched socio-cultural norms, continue to undermine
progress. This study investigates the perceptions, experiences, and factors affecting maternal
health service utilisation (MHSU) among Nigerian women aged 15–19. Specifically, it assesses
patterns and prevalence of utilisation, examines socio-demographic determinants, and explores
how women’s lived experiences and perceptions shape care-seeking behaviour. Employing a
cross-sectional analytical design, the study draws on secondary data from the Nigeria Multiple
Indicator Cluster Survey (MICS) 2021, which covered over 39,000 households nationwide.
Complementary qualitative data from Kwara and Osun states further illuminate women’s
perspectives. Findings indicate that while initial contact with ANC is relatively high, adequacy
of care, skilled delivery, and timely postnatal care remain sub-optimal. Maternal education,
household wealth, and urban residence significantly enhance utilisation, whereas socio-cultural
constraints and poor service quality hinder uptake. The study underscores the need for multilevel interventions addressing financial, infrastructural, and cultural barriers to accelerate
equitable maternal health coverage in Nigeria.
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