INVESTIGATING REGIONAL DISPARITIES IN THE SPATIAL PATTERN AND DETERMINANTS OF ANTENATAL CARE UTILIZATION IN NORTHERN AND SOUTHERN NIGERIA

Abstract

The persistent uneven utilization of Antenatal care (ANC) across Nigeria, a very important factor for improving maternal and child health outcomes, has been a major challenge in meeting up with the SDG goals. The major disparities has been between Northern and Southern regions. Leveraging on the  use of the 2013 Nigeria Demographic and Health Survey (NDHS), which offers a more comprehensive geographic dataset than NDHS 2018, this study employed the Bayesian spatial geo-additive modeling technique to analyse the spatial and determinant factors influencing ANC utilization among pregnant women in the two regions.  The Structured Additive Regression model (STAR) was used to simultaneously analyze the components of the model. The results show that the major determinants of ANC utilization in the two regions are mothers’ education, religious affiliation, economic empowerment, and urban residence with significant regional differences. Northern Nigeria shows significantly lower ANC uptake while Southern Nigeria records higher ANC utilization. Urban-rural disparities however persist. Clusters of low ANC utilization were identified by spatial analysis in the northern states, reflecting regional inequalities in maternal healthcare access. This study concludes that in order to improve ANC utilization across Nigeria,  interventions should be region specific, and be tailored towards addressing specific social, cultural and economic challenges in each region.