title: Maternal Health Care Services Access Index and Infant Survival in Nigeria.
abstract: BACKGROUND
  Infant mortality rate in Nigeria is among the highest world-wide. Utilization of modern health care facilities during pregnancy and at delivery reduces infant mortality rate. We examined the relationship between Infant Mortality (IM) and Maternal Health Care Services Access Index (MHCI) in Nigeria.
  
  
  METHODS
  This cross-sectional study utilized 2013 NDHS data and included women aged 15-49 years (n=12511). MHCI was obtained from information on antenatal visit, antenatal attendance, tetanus toxoid injection during pregnancy, place of delivery and birth attendance. Cox-proportional hazard and Brass models were used for the analysis (α=0.05).
  
  
  RESULTS
  Mean MHCI was higher among women with lower prevalence of IM. About 5.1% and 3.4% of the women with none and complete MHCI had experienced infant deaths respectively. The hazard of experienced infant deaths was 1.497(1.068-2.098) and 1.466(1.170-1.836) significantly higher among women with no and low MHCI respectively than those with complete MHCI. This pattern was observed when other factors were used as control. The refined IM probability (range=0.0482-0.1102) and IM rates (range=50-119) increased with reduction in the level of MHCI. The IM rate reduces from 119 per 1,000 live births among women whose MHCI score was zero to 50 per 1,000 live births among those with complete MHCI score.
  
  
  CONCLUSIONS
  Infant death was least experienced among women who had complete MHCI. If women optimize utilization of health facility during pregnancy and delivery, infant deaths will reduce in Nigeria.
authors.affiliation: Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Adebowale
authors.initials: A
authors.lastname: Sa
authors.affiliation: 2Bureau of Marketing Research, University of South Africa, South Africa.
authors.forename: Udjo
authors.initials: U
authors.lastname: E
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Delivery care; Infant mortality; Maternal health care; Nigeria; Pregnancy care