CROSS – NATIONAL REVIEW ON SOCIAL DETERMINANTS OF ACCESS AND UTILIZATION OF ANTENATAL CARE SERVICES AMONG WOMEN OF REPRODUCTIVE AGE: INSIGHTS FOR EDO STATE, NIGERIA

Abstract

Antenatal care (ANC) is an essential care designed to ensure the best services and health outcomes for women and children. Pregnant women, ideally, should have at least eight contacts with a healthcare provider initiated within less than 12 weeks gestational age. This is in order to gain person-centered care and prevent child and maternal mortality. This paper reviewed the social determinants of access and utilization of ANC services among women of reproductive age across societies in purposively chosen five nation states of India, China, Ghana, Ethopia and Nigeria.The purpose of the review was to draw lessons that will benefit Edo State in South-South Region of Nigeria which has recorded low ANCaccess and utilization, as well as high maternal deaths in recent times. Anchored on Andersen Ronald’s (1968) Behavioral Model of Health Services Use (BMHSU), the review elicited information via secondary sources to serve as lessons and assist maternal and child healthcare providers in Edo State, Nigeria to achieve optimum levels of access and utilization of their service. Specifically, the review revealed that scholars identified elements like place of residence, education, culture, spatial disparity of health facilities among others as relevant to access and utilization of ANC in the five aforementioned countries. The reviewed works recommended improving women’s educational achievement, and introduction of peer education programs to mobilize and support women. They also advocated for programs to change husbands’ attitudes, and to enrich the quality of antenatal care through increasing health extension worker’s home visits program, and increasing the awareness of pregnancy complications. The need for strong advocaccy and education of male partners on the importance of supporting their spouse and payment for facility-based maternal services without undermining their traditional decision-making roles was also strongly stressed. These measures if implemented in Edo State, Nigeria will contribute immensely to meeting the goals of ANC in the state.