Patterns, determinants, and outcomes of antenatal care services utilization among rural and urban women in north-western Nigeria: A comparative analysis

Background: Antenatal care (ANC) services have been globally lauded as having positive effects on pregnancy outcomes and reducing maternal and perinatal mortalities. However, the utilization of ANC is not uniform among its target population, particularly in rural areas of sub-Saharan Africa and south Asia. Objective: The objective is to ascertain and compare the patterns, determinants, and outcomes of ANC utilization among rural and urban women of child-bearing age in Kaduna State, north-western Nigeria by using a comparative, community-based, cross-sectional, descriptive study design among 340 women in a rural (n = 170) and an urban (n = 170) community. Materials and Methods: Respondents were selected by cluster sampling and multistage sampling methods in the rural and urban areas, respectively. Data were collected by using a structured, self-administered questionnaire and analyzed by using Statistical Package for Social Sciences (SPSS), version 25. Results were presented in tables, and associations were tested by using chi-square (x2) test. Results: Most of the respondents were between 25 and 29 years, more than 80% were married, and only 23.5% (rural) and 38.8% (urban) had a post-secondary level of education. The ANC attendance was 61.8%, representing 210 out of the 340 respondents (rural 40.6%, urban 82.9%). Among the ANC attendees, 71% initiated ANC in the first trimester (rural 60.9%, urban 75.9%) and 61.4% had at least four visits (rural 56.5%, urban 63.8%). The determinants of ANC utilization were mainly levels of education and incomes of the respondents and/ or their husbands. Conclusion: A consistent pattern of rural–urban disparities was demonstrated in diverse aspects of ANC utilization, including the determinants and outcomes thereof, with better indices among urban women relative to rural women. These findings underscore the need to bridge the gap between rural and urban areas. Priority attention needs to be given to the spatial (geographical) siting of health facilities, literacy, and financial standing of both women and their husbands.