Barriers To Antenatal Care Utilisation Among Women in Bauchi Local Government Area, North-Eastern Nigeria: A Cross-Sectional Study
Keywords:
Antenatal care, Barriers, Health-system access, Maternal health, Nigeria, UtilisationAbstract
Antenatal care (ANC) remains under-utilised in many parts of northern Nigeria despite decades of health education investment, and the specific barriers that keep attendance below recommended thresholds are not always adequately characterised at the local-government level. This community-based, cross-sectional study assessed the prevalence and pattern of barriers to ANC utilisation among 405 women who had delivered within the preceding 6–12 months in six wards of Bauchi Local Government Area (LGA), Bauchi State, Nigeria, recruited through multi-stage random sampling. A structured, interviewer-administered questionnaire captured sociodemographic characteristics, ANC utilisation indicators, and self-reported barriers to attendance. Adequate utilisation was defined as four or more ANC visits; associations were tested using chi-square analysis and multivariable logistic regression. Overall, among the 401 women who had attended at least one ANC visit, 76.3% achieved adequate utilisation, but initiation was frequently delayed, with only 42.5% booking in the first trimester. The most frequently reported barriers were lack of money (29.1%), transport difficulties (20.7%), long waiting time (18.0%), poor staff attitude (11.4%), lack of privacy (9.6%), drug unavailability (5.9%), and perceiving oneself as healthy (5.2%). Adequate utilisation was significantly associated with educational attainment and maternal age but not with knowledge or attitude scores. These findings indicate that ANC utilisation gaps in Bauchi LGA are driven predominantly by financial, logistic, and health-system access barriers layered onto structural sociodemographic disadvantage, rather than by deficits in awareness or willingness to attend. Addressing cost, transport, and service-quality barriers, alongside targeted support for younger and less-educated women, is likely to yield greater gains in ANC utilisation than health-education messaging alone.
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