The aim of the newly introduced “focused Antenatal Care
(ANC)” is not only to achieve a minimum number of 4 visits, but also the
timeliness of the commencement of the visits as well as the quality and
relevance of services offered during the visits. This study is therefore
designed to assess the quality of ANC services in Nigeria.
We used information supplied by the 13410 respondents who
claimed to have used the ANC facilities at least once within five year
preceding the 2013 Nigeria Demographic and Household Survey (NDHS). Ten components
of ANC including: offer of HIV test, Tetanus Toxoid injection, receiving
iron supplementation, intermittent preventive treatment (IPT), intestinal
preventive drug (IPD), timely ANC enrollment and number of visits were
assessed. Receipts of all the ten components were classified as desirable
(good) quality of ANC services while receipt of eight critical components among
the ten were assumed to be the minimum acceptable quality. Data was weighted
and analyzed using descriptive statistics and logistic regression models at
5 % significance level.
Measurement of blood pressure and receiving iron
supplementation were the most commonly offered ANC component in Nigeria with
91.0 % each while IPD and IPT were given to only 20.7 % and 37.6 %
respectively. Less than two thirds were taught on PMTCT while 41.7 % had
HIV test and obtained results. Only 4.6 % (95 % CI: 4.2–5.1) of women
received good quality of ANC while nearly 1.0 % did not receive any of the
components. About 11.3 % (95 % CI: 10.6–11.9 %) of the attendees
had minimum acceptable quality of ANC. Receipt of good quality ANC services was
higher among users who initiated ANC early, had at least 4 ANC visits, attended
to by skilled health workers, attended government and private hospitals and
clinics. Higher odds of receiving good quality of ANC were found among users
who lives in urban areas, having higher educational attainment, belonging to
households in upper wealth quintiles and attended to by skilled ANC provider.
The levels of desirable and minimum acceptable quality of
ANC services were poor in Nigeria thereby jeopardizing efforts to achieve the
MDGs. There is need for intensified commitment by national and state
governments in Nigeria as well as other stakeholders to ensure that main
components of ANC are received by the users.
Below: Distribution of ANC components received by the users
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