Antenatal care services utilization among women of reproductive age in urban and rural communities of south east Nigeria: A comparative study.

Background: Antenatal care is an evidence based intervention that improves maternal and perinatal outcome. Assessment and re-assessment of its utilization by rural and urban women in Nigeria is necessary for planning healthcare programmes and interventions. Aim: This study aims to assess urban – rural differences in antenatal care services utilization among women in South-East Nigeria and factors that influence such. Methodology: This is a cross-sectional study carried out among women of reproductive age in Anambra State, South-East Nigeria. Participants were selected using multistage sampling technique. Data was collected using pre-tested, semi-structured questionnaires which were interviewer-administered. Data obtained was analyzed using SPSS version 17. Tests of significance were done using Chi square test and student T test at 95% confidence intervals. Results: Six hundred women were included in the study; 300 respectively, from urban and rural settings. The mean age of respondents was 33.9+2.7 years. The average month at booking was higher in the rural areas (5.2 months) when compared to the urban (4.4) months, with more respondents in the urban areas booking earlier (P=0.000). More respondents in the urban, 140 (50.8%), attended ANC up to 4 times when compared to their rural counterparts, 102(37.0%) (p= 0.000). Women in the urban areas were more likely to have deliveries supervised by skilled birth attendants (p= 0.000). The estimated cost of antenatal care was higher in the urban areas than the rural (p= 0.000). Satisfaction received from antenatal and delivery services was also higher in the urban settings (p= 0.000). Conclusion: Rural-urban differences exist in the utilization of antenatal care services, with a higher proportion of urban women utilizing these services. Increased health education of women, especially in the rural areas, is advocated. Key Words : Antenatal utilization, Rural, Urban, Women, Nigeria.