Use of Antenatal Services and Delivery Care among Women in Northern Nigeria

Henry V. Doctor, Columbia University
Sally E. Findley, Columbia University
Tukur Dahiru, Ahmadu Bello University
Giorgio Cometto, Save the Children UK
Cathy Green, Health Partners International

Maternal mortality in Northern Nigeria is among the highest in the world. To guide programme planning we interviewed 7442 women in three northern states to understand patterns of antenatal care (ANC) and delivery. During their last pregnancy, 67.4% sought no advice, and only 24.9% had ANC at a clinic. At these visits, most had their weight and blood pressure checked and received anti-tetanus vaccination, while 57-65% received counseling about complications, breastfeeding, or newborn care. 90.7% delivered at home. Over half preferred home delivery because of comfort and convenience, while the balance were prevented from delivery at a facility by barriers of cost, transport, spousal permission, cultural norms, or health worker’s attitude. Those delivering in a facility had complications (43.7%) or viewed a facility as safer (19.4%) or offering better care (25.7%). Our programs must increase awareness of pregnancy and delivery complications while reducing barriers to assessing risk and accessing facilities.