title: Socio-demographic determinants of maternal health-care service utilization among rural women in anambra state, South East Nigeria.
abstract: BACKGROUND
  Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization.
  
  
  OBJECTIVE
  This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio-demographic factors influencing it in Anambra State, South East Nigeria.
  
  
  METHODS
  A total of 310 women of reproductive age with a previous history of gestation attending ANC services between September, 2007 and August, 2008 in selected Primary Health Centers in Anambra State were studied. Responses were elicited from the study participants using a pre-tested, semi-structured interviewer-administered questionnaire. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 17 (SPSS Inc, Chicago Illinois, USA). Association between socio-demographic characteristics and pattern of utilization of ANC and delivery services was measured using χ(2)-test, Regression analysis was done to identify factors associated with utilization of MH services. P < 0.05 was assumed to be significant.
  
  
  RESULTS
  Use of health facility was 293 (97.0%) and 277 (92,7%) out 302 women for ANC and delivery services respectively. Most women attended their first ANC consultation during the preceding pregnancy was after the first trimester and about 31% (94/298) of them had <4 ANC visits prior to delivery. Socio-demographic factors were found to be significantly associated with places where MH care services are accessed. Parity was found to be associated with timing of ANC booking and number of ANC attendance (χ(2) = 9.49, P = 0.05). Odds of utilizing formal health facility for MH services were found to be significantly associated with increasing age (P < 0.01) and educational status of mothers (P < 0.001).
  
  
  CONCLUSIONS
  The study revealed high maternal service utilization and 10% fetal loss, hence the need to address the gaps of late ANC booking and low ANC visits.
authors: Department of Community Medicine, Nnamdi Azikiwe University, Nnewi, Anambra, Nigeria.
authors: Of
authors: O
authors: Emelumadu
authors: Department of Community Medicine, Federal Medical Center, Umuahia, Nigeria.
authors: Au
authors: A
authors: Ukegbu
authors: Department of Community Medicine, Nnamdi Azikiwe University, Nnewi, Anambra, Nigeria.
authors: Nn
authors: N
authors: Ezeama
authors: Department of Neurosurgery, Lagos State University, Lagos, Nigeria.
authors: Oo
authors: O
authors: Kanu
authors: Department of Community Medicine, Nnamdi Azikiwe University, Nnewi, Anambra, Nigeria.
authors: Co
authors: C
authors: Ifeadike
authors: Department of Community Medicine, Abia State University, Aba Campus, Aba, Abia State, Nigeria.
authors: Uu
authors: U
authors: Onyeonoro
keywords: Antenatal care; Delivery; Determinants; Nigeria; Parity; Rural