Main Article Content
Abstract
Background: Quality antenatal care is crucial for achieving Sustainable Development Goals in both developing and developed countries. This study aimed to identify factors hindering the quality of antenatal care among pregnant women attending primary healthcare facilities in Ede South, Osun State, Nigeria.
Methods: A descriptive cross-sectional study was conducted, and data were collected using questionnaires. We used Chi-square and multivariable logistic regression for data analysis.
Results: Factors that significantly hindered the quality of antenatal care included healthcare workers not rendering services promptly (p=0.001; AOR=2.87; CI=1.55-5.3), lack of modern equipment (p=0.00; AOR=4.23; CI=2.13-7.75), and healthcare workers lacking sufficient skills (p=0.01; AOR=2.4; CI=1.23-4.68). No significant association was found between socio-demographic variables and perceived quality of antenatal care.
Conclusion: Pregnant women perceive good-quality antenatal care at primary healthcare centers. However, factors such as delayed services, outdated equipment, and inadequate healthcare workers’ skills significantly hinder the quality of care. Addressing these factors could improve the quality of antenatal care services in primary healthcare facilities in Ede South, Osun State, Nigeria.
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Article Details
Copyright (c) 2025 Aderinto Adebimpe , Oshineye Adeola, Olarinmoye Abayomi, Akin Oyebade, Akin Ajayi, James Ebun Atolagbe

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
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- Adedokun, S. T, Yaya, S. (2020). Correlates of Antenatal Care Utilization among Women of Reproductive Age in Sub-Saharan Africa: Evidence from Multinomial Analysis of Demographic and Health Surveys (2010-2018) from 31 countries. Arch Public Health,78(1), 134.
- Adewuyi, E.O., Auta, A, Khanal, V., Bamidele, O. D., Akuoko, C. P, Adefemi, K., Tapshak, S. J., Zhao, Y. (2018). Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey, PloS One, 13(5): e0197324.
- Adeyemi, A., Ahmed, A., Isiugo-Abanihe, U., Hussain, I., & Oladokun, A. (2019). Trends and determinants of antenatal care use in Nigeria: A pooled analysis of Demographic and Health Surveys. BMC Pregnancy Childbirth, 19(1), 98.
- Adhikari, M., Chalise, B., Bista, B. et al., (2020). Sociodemographic correlates of antenatal care visits in Nepal: results from Nepal Demographic and Health 2016. BMC Pregnancy Childbirth 20, 513. https://doi.org/10.1186/s12884-020-03218-x
- Aduloju, O., Ujioma, U., Morakinyo, O., Oke, B., & Agan, D. (2020). Quality of antenatal care services in Nigeria: A systematic review. BMC Pregnancy Childbirth, 20(1), 334.
- Afulani, P. A., Buback, L., Essandoh, F., Kinyua, J., Kirumbi, L., & Cohen, C. R. (2019). Quality of antenatal care and associated factors in a rural county in Kenya: an assessment of service provision and experience dimensions. BMC Health Services Research, 19, 1-16.
- Aghajani, F., Maajani, K., Nakhostin-Ansari, A., Maleki-Hajiagha, A., Aghajani, R., & Tehranian, A. (2022). Maternal mortality and its determining factors among hospitalised mothers in Tehran, Iran, 2013–2020. Journal of Obstetrics and Gynecology, 42(6), 1905-1910.
- Ahuru, R. R., Okungbowa, O. G., Iseghohi, J. O., Akpojubaro, E. H. (2021). Non-utilization of Primary Healthcare Centres for Skilled Pregnancy Care among Women in Rural Communities in Delta State, Southern Nigeria: Perspectives from Mothers, Fathers, and Healthcare Providers. J Int Women’s Stud., 22(9), 142–59.
- Ajegbile, M. L., (2023). Closing the gap in maternal health access and quality through targeted investments in low-resource settings. J Global Health Rep.Oct;13(7): e2023070.
- Akachi, I. U., Nwagha, D. I., & Akubuiro, A. C. (2017). The prevalence, determinants and consequences of low-quality antenatal care in Ebonyi State, South-East, Nigeria. BMC Pregnancy and Childbirth, 17(1), 1-9.
- Aregbeshola, B. S., Khan, S. M. (2017). Primary health care in Nigeria: 24 years after Olikoye Ransome-Kuti’s leadership. Front Public Health,13(5), 218936.
- Arsenault, C., Jordan, K., Lee, D., Dinsa, G., Manzi, F., Marchant, T., & Kruk, M. E. (2018). Equity in antenatal care quality: an analysis of 91 national household surveys. The Lancet Global Health,6(11), e1186–e95.
- Azodoh, V. N., Ijadunola, Y. M., Bamidele, M. (2021). Quality of Antenatal Care Services in Primary Healthcare Centers in the Federal Capital Territory, Abuja, Nigeria: A Cross-sectional Study. Anatol J Family Med, 14(3), 232–237.
- Catalano, E. A. (2020). What does it take to achieve high quality antenatal care? Evidence from antenatal care quality assessments conducted in four countries. Maternal Health, Neonatology & Perinatology, 6(1).
- El-Khatib, Z., Kolawole Odusina, E, Ghose, B., & Yaya, S. (2020). Patterns and Predictors of Insufficient Antenatal Care Utilization in Nigeria over a Decade: A Pooled Data Analysis Using Demographic and Health Surveys. International Journal of Environmental Research and Public Health, 17(21), 8261.
- Eluobaju, D., Okonofua, F., Weine, S., Goba, G. (2023). Understanding birthing preferences of women in Benin City, Nigeria: a qualitative study. BMJ Open;13(5), e054603.
- Fawole, O., Osoba, O., Malomo, S., & Adegboye, O. (2020). Factors influencing the utilization of antenatal care in Nigeria: A population-based study. The Pan African Medical Journal, 35(2), 10.
- Fesseha, G., Alemayehu, M., Etana, B., Haileslassie, K., & Zemene, A. (2014). Perceived quality of antenatal care service by pregnant women in public and private health facilities in Northern Ethiopia. American Journal of Health Research, 2(4), 146-151.
- Hijazi, H. H., Alyahya, M. S., Sindiani, A. M., Saqan, R. S., & Okour, A. M. (2018). Determinants of antenatal care attendance among women residing in highly disadvantaged communities in northern Jordan: a cross-sectional study. Reproductive health, 15, 1-18.
- Johnson, O. E., Obidike, P. C., Eroh, M. U., Okpon, A. A., Bassey, E. I., Pascal, C. E., Princewill, E., Ojumah, E. (2020). Choices and Determinants of Delivery Location among Mothers Attending a Primary Health Facility in Southern Nigeria. Nigerian Postgraduate Medical Journal. 27(1), 42-48.
- Joshi, C., Torvaldsen, S., Hodgson, R., & Hayen, A. (2014). Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC pregnancy and childbirth, 14, 1-11.
- Konlan, K. D., Saah, J. A., Amoah, R. M., Doat, A. R., Mohammed, I., Abdulai, J. A., Konlan, K. D. (2020). Factors Influencing the Utilization of Focused Antenatal Care Services during Pregnancy, A Study among Postnatal Women in a Tertiary Healthcare Facility, Ghana. Nurs Open; 26; 7(6): 1822-1832. https://doi.org/10.1002/nop2.569.
- Kyei-Nimakoh, M., Afolabi, S., Amoako, P., & Atuire, C. (2017). Access barriers to obstetric care at health facilities in sub-Saharan Africa—a systematic review. Systematic Reviews, 6(1), 110.
- Majrooh, M. A., Hasnain, S., Akram, J., Siddiqui, A., & Memon, Z. A. (2014). Coverage and quality of antenatal care provided at primary health care facilities in the Punjab province of Pakistan. Plos one, 9(11), e113390.
- Makonnen, Y., Bulti, D. & Woldie, M. (2017) 'Assessment of quality of antenatal care services in public health facilities in Jimma Zone, Southwest Ethiopia', BMC Health Services Research, 17(1), 1-11.
- McCauley, H., Lowe, K., Furtado, N., Mangiaterra, V., & van den Broek, N. (2022). What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation. BJOG: An International Journal of Obstetrics and Gynaecology, 129(6), 855–867.
- Muchie, K. F., (2017). Quality of antenatal care services and completion of four or more antenatal care visits in Ethiopia: a finding based on a demographic and health survey. BMC Pregnancy and Childbirth, 17(1),1–7.
- Mwanja, M. M., & Kazonga, E. (2022). Factors influencing satisfaction of the quality of antenatal care services in health facilities in Lusaka district: a cross-sectional study. International Journal of Community Medicine and Public Health, 10(1), 70–77. https://doi.org/10.18203/2394-6040.ijcmph20223528
- National Population Commission (NPC) [Nigeria] and ICF International. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
- Ntoimo, L. F., Okonofua, F. E., Ekwo, C., Solanke, T. O., Igboin, B., Imongan, W., Yaya, S., (2022). Why women utilize traditional rather than skilled birth attendants for maternity care in rural Nigeria: Implications for policies and programs. Midwifery; 1(104), 103158.
- Okafor, O., Bello, R., Obino, C., Adesiyun, A., Ofoegbu, E., & Akinyemi, R. (2015). Disrespect and abuse during facility-based childbirth in a low-income country. International Journal of Gynecology and Obstetrics. 128(2),110-113.
- Okonofua, F., Ntoimo, L. F., Yaya, S., Igboin, B., Solanke, O., Ekwo, C., Johnson, E. A., Sombie, I., Imongan, W. (2022). Effect of a multifaceted intervention on the utilization of primary health for maternal and child health care in rural Nigeria: a quasi-experimental study. BMJ Open, 12(2), e049499
- Oladimeji, O. J., & Fatusi, A. O., (2022). Realist evaluation of the “Abiye” safe motherhood initiative in Nigeria: unveiling the black box of program implementation and health system strengthening. Frontiers in Health Services;10(2), 779130
- Panneerselvam, S. (2017). Quality of care in maternal and child health. In S. Panneerselvam (Ed.), Maternal and Child Health Nursing, 23-38
- Tadesse, B. T., & Modibia, L. M. (2020). Assessment of quality of antenatal care services and its determinant factors in public health facilities of Hossana town, Hadiya zone, Southern Ethiopia: A Longitudinal Study. Adv Public Health, 1–11.
- Tawose, O.V, Ayinde, A.O, Folahanm, T.A, Akinoye, J.I, Micheal, O.O, Falana, F.P., (2023). Investigation into Factors Causing Pregnant Women in Ede South Local Government Area, Osun State, To Underutilize Antenatal Care Services. International Journal of Health Systems and Medical Science, 2 (3), 2833-7433
- Tesfay, N., Hailu, G., and Woldeyohannes, F. (2023). Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Front Pediatr, 1130.
- Udenigwe, O, Okonofua, F. E., Ntoimo, L. F., Yaya, S., (2023). Seeking maternal health care in rural Nigeria: through the lens of negofeminism. Reproductive Health; 20(1),103.
- Umar AS (2017). Women Autonomy and the Use of Antenatal and Delivery Services in Nigeria. MOJ Public Health 6(2): 00161.doi: 10.15406/mojph.06.00161
- World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization.
References
Abubakari, A., Agbozo, F., & Abiiro, G.A. (2017). Factors associated with optimal antenatal care use in the northern region. Ghana Women Health, 58, 942 54.
Adedokun, S. T, Yaya, S. (2020). Correlates of Antenatal Care Utilization among Women of Reproductive Age in Sub-Saharan Africa: Evidence from Multinomial Analysis of Demographic and Health Surveys (2010-2018) from 31 countries. Arch Public Health,78(1), 134.
Adewuyi, E.O., Auta, A, Khanal, V., Bamidele, O. D., Akuoko, C. P, Adefemi, K., Tapshak, S. J., Zhao, Y. (2018). Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey, PloS One, 13(5): e0197324.
Adeyemi, A., Ahmed, A., Isiugo-Abanihe, U., Hussain, I., & Oladokun, A. (2019). Trends and determinants of antenatal care use in Nigeria: A pooled analysis of Demographic and Health Surveys. BMC Pregnancy Childbirth, 19(1), 98.
Adhikari, M., Chalise, B., Bista, B. et al., (2020). Sociodemographic correlates of antenatal care visits in Nepal: results from Nepal Demographic and Health 2016. BMC Pregnancy Childbirth 20, 513. https://doi.org/10.1186/s12884-020-03218-x
Aduloju, O., Ujioma, U., Morakinyo, O., Oke, B., & Agan, D. (2020). Quality of antenatal care services in Nigeria: A systematic review. BMC Pregnancy Childbirth, 20(1), 334.
Afulani, P. A., Buback, L., Essandoh, F., Kinyua, J., Kirumbi, L., & Cohen, C. R. (2019). Quality of antenatal care and associated factors in a rural county in Kenya: an assessment of service provision and experience dimensions. BMC Health Services Research, 19, 1-16.
Aghajani, F., Maajani, K., Nakhostin-Ansari, A., Maleki-Hajiagha, A., Aghajani, R., & Tehranian, A. (2022). Maternal mortality and its determining factors among hospitalised mothers in Tehran, Iran, 2013–2020. Journal of Obstetrics and Gynecology, 42(6), 1905-1910.
Ahuru, R. R., Okungbowa, O. G., Iseghohi, J. O., Akpojubaro, E. H. (2021). Non-utilization of Primary Healthcare Centres for Skilled Pregnancy Care among Women in Rural Communities in Delta State, Southern Nigeria: Perspectives from Mothers, Fathers, and Healthcare Providers. J Int Women’s Stud., 22(9), 142–59.
Ajegbile, M. L., (2023). Closing the gap in maternal health access and quality through targeted investments in low-resource settings. J Global Health Rep.Oct;13(7): e2023070.
Akachi, I. U., Nwagha, D. I., & Akubuiro, A. C. (2017). The prevalence, determinants and consequences of low-quality antenatal care in Ebonyi State, South-East, Nigeria. BMC Pregnancy and Childbirth, 17(1), 1-9.
Aregbeshola, B. S., Khan, S. M. (2017). Primary health care in Nigeria: 24 years after Olikoye Ransome-Kuti’s leadership. Front Public Health,13(5), 218936.
Arsenault, C., Jordan, K., Lee, D., Dinsa, G., Manzi, F., Marchant, T., & Kruk, M. E. (2018). Equity in antenatal care quality: an analysis of 91 national household surveys. The Lancet Global Health,6(11), e1186–e95.
Azodoh, V. N., Ijadunola, Y. M., Bamidele, M. (2021). Quality of Antenatal Care Services in Primary Healthcare Centers in the Federal Capital Territory, Abuja, Nigeria: A Cross-sectional Study. Anatol J Family Med, 14(3), 232–237.
Catalano, E. A. (2020). What does it take to achieve high quality antenatal care? Evidence from antenatal care quality assessments conducted in four countries. Maternal Health, Neonatology & Perinatology, 6(1).
El-Khatib, Z., Kolawole Odusina, E, Ghose, B., & Yaya, S. (2020). Patterns and Predictors of Insufficient Antenatal Care Utilization in Nigeria over a Decade: A Pooled Data Analysis Using Demographic and Health Surveys. International Journal of Environmental Research and Public Health, 17(21), 8261.
Eluobaju, D., Okonofua, F., Weine, S., Goba, G. (2023). Understanding birthing preferences of women in Benin City, Nigeria: a qualitative study. BMJ Open;13(5), e054603.
Fawole, O., Osoba, O., Malomo, S., & Adegboye, O. (2020). Factors influencing the utilization of antenatal care in Nigeria: A population-based study. The Pan African Medical Journal, 35(2), 10.
Fesseha, G., Alemayehu, M., Etana, B., Haileslassie, K., & Zemene, A. (2014). Perceived quality of antenatal care service by pregnant women in public and private health facilities in Northern Ethiopia. American Journal of Health Research, 2(4), 146-151.
Hijazi, H. H., Alyahya, M. S., Sindiani, A. M., Saqan, R. S., & Okour, A. M. (2018). Determinants of antenatal care attendance among women residing in highly disadvantaged communities in northern Jordan: a cross-sectional study. Reproductive health, 15, 1-18.
Johnson, O. E., Obidike, P. C., Eroh, M. U., Okpon, A. A., Bassey, E. I., Pascal, C. E., Princewill, E., Ojumah, E. (2020). Choices and Determinants of Delivery Location among Mothers Attending a Primary Health Facility in Southern Nigeria. Nigerian Postgraduate Medical Journal. 27(1), 42-48.
Joshi, C., Torvaldsen, S., Hodgson, R., & Hayen, A. (2014). Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC pregnancy and childbirth, 14, 1-11.
Konlan, K. D., Saah, J. A., Amoah, R. M., Doat, A. R., Mohammed, I., Abdulai, J. A., Konlan, K. D. (2020). Factors Influencing the Utilization of Focused Antenatal Care Services during Pregnancy, A Study among Postnatal Women in a Tertiary Healthcare Facility, Ghana. Nurs Open; 26; 7(6): 1822-1832. https://doi.org/10.1002/nop2.569.
Kyei-Nimakoh, M., Afolabi, S., Amoako, P., & Atuire, C. (2017). Access barriers to obstetric care at health facilities in sub-Saharan Africa—a systematic review. Systematic Reviews, 6(1), 110.
Majrooh, M. A., Hasnain, S., Akram, J., Siddiqui, A., & Memon, Z. A. (2014). Coverage and quality of antenatal care provided at primary health care facilities in the Punjab province of Pakistan. Plos one, 9(11), e113390.
Makonnen, Y., Bulti, D. & Woldie, M. (2017) 'Assessment of quality of antenatal care services in public health facilities in Jimma Zone, Southwest Ethiopia', BMC Health Services Research, 17(1), 1-11.
McCauley, H., Lowe, K., Furtado, N., Mangiaterra, V., & van den Broek, N. (2022). What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation. BJOG: An International Journal of Obstetrics and Gynaecology, 129(6), 855–867.
Muchie, K. F., (2017). Quality of antenatal care services and completion of four or more antenatal care visits in Ethiopia: a finding based on a demographic and health survey. BMC Pregnancy and Childbirth, 17(1),1–7.
Mwanja, M. M., & Kazonga, E. (2022). Factors influencing satisfaction of the quality of antenatal care services in health facilities in Lusaka district: a cross-sectional study. International Journal of Community Medicine and Public Health, 10(1), 70–77. https://doi.org/10.18203/2394-6040.ijcmph20223528
National Population Commission (NPC) [Nigeria] and ICF International. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
Ntoimo, L. F., Okonofua, F. E., Ekwo, C., Solanke, T. O., Igboin, B., Imongan, W., Yaya, S., (2022). Why women utilize traditional rather than skilled birth attendants for maternity care in rural Nigeria: Implications for policies and programs. Midwifery; 1(104), 103158.
Okafor, O., Bello, R., Obino, C., Adesiyun, A., Ofoegbu, E., & Akinyemi, R. (2015). Disrespect and abuse during facility-based childbirth in a low-income country. International Journal of Gynecology and Obstetrics. 128(2),110-113.
Okonofua, F., Ntoimo, L. F., Yaya, S., Igboin, B., Solanke, O., Ekwo, C., Johnson, E. A., Sombie, I., Imongan, W. (2022). Effect of a multifaceted intervention on the utilization of primary health for maternal and child health care in rural Nigeria: a quasi-experimental study. BMJ Open, 12(2), e049499
Oladimeji, O. J., & Fatusi, A. O., (2022). Realist evaluation of the “Abiye” safe motherhood initiative in Nigeria: unveiling the black box of program implementation and health system strengthening. Frontiers in Health Services;10(2), 779130
Panneerselvam, S. (2017). Quality of care in maternal and child health. In S. Panneerselvam (Ed.), Maternal and Child Health Nursing, 23-38
Tadesse, B. T., & Modibia, L. M. (2020). Assessment of quality of antenatal care services and its determinant factors in public health facilities of Hossana town, Hadiya zone, Southern Ethiopia: A Longitudinal Study. Adv Public Health, 1–11.
Tawose, O.V, Ayinde, A.O, Folahanm, T.A, Akinoye, J.I, Micheal, O.O, Falana, F.P., (2023). Investigation into Factors Causing Pregnant Women in Ede South Local Government Area, Osun State, To Underutilize Antenatal Care Services. International Journal of Health Systems and Medical Science, 2 (3), 2833-7433
Tesfay, N., Hailu, G., and Woldeyohannes, F. (2023). Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Front Pediatr, 1130.
Udenigwe, O, Okonofua, F. E., Ntoimo, L. F., Yaya, S., (2023). Seeking maternal health care in rural Nigeria: through the lens of negofeminism. Reproductive Health; 20(1),103.
Umar AS (2017). Women Autonomy and the Use of Antenatal and Delivery Services in Nigeria. MOJ Public Health 6(2): 00161.doi: 10.15406/mojph.06.00161
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization.