title: Barriers to utilisation of maternal health services in a semi-urban community in northern Nigeria: The clients' perspective.
abstract: BACKGROUND
  Low level of utilisation of maternal health services is a major factor responsible for high maternal mortality in northwestern region of Nigeria. This study was aimed at determining the barriers to utilisation of maternal health services from the perspective of mothers in northwestern Nigeria.
  
  
  METHODS
  A cross-sectional study of 150 mothers, selected through multistage technique, was conducted. Data were collected using a structured interviewer-administered questionnaire, and analysed using SPSS statistics 17.0.
  
  
  RESULTS
  Only 2.7% utilised preconception service, 98.7% antenatal care service (ANC), 24.0% delivery, 35.3% postnatal care and 14.0% utilised family planning service. Major reasons for non-utilisation of delivery service were not having a delivery complication in the past (57% (CI = 47.4-66.1)) and negative provider attitude (23.7% (CI = 16.4-32.7)). For non-utilisation of postnatal care, the major reasons were also not having a postnatal complication in the past (60.8% (CI = 50.4-70.4)) and negative provider attitude (27.8% (CI = 19.4-38.0)). As for non-utilisation of family planning service, the major reason was desire to have more children (32.6% (CI = 24.7-41.4)). Reasons for non-use of preconception care and ANC were not computed because respondents to these questions were not enough; only 6 (4.0%) were aware of preconception care in the first place and only 2 (1.3%) were not using ANC.
  
  
  CONCLUSIONS
  Despite living near a health facility, most of the mothers were not using maternal health services. It is recommended that while there is the need to raise awareness on the utilisation of maternal health services, bring it closer to the mothers and make it more affordable, there is a more pressing need to improve its quality, especially through the alleviation of negative attitude of health care providers.
authors: Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
authors: Suleman Hadejia
authors: SH
authors: Idris
authors: Mohammed Nasir
authors: MN
authors: Sambo
authors: Muhammed Sani
authors: MS
authors: Ibrahim
keywords: Maternal health; northwestern Nigeria; rural community
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