Determinants of adequate antenatal care utilization among Nigerian women

Nigeria faces significant challenges in improving maternal health, particularly regarding antenatal care (ANC). Many women do not receive the recommended eight visits, and some forgo care altogether. Therefore, this study aims to explore the socioeconomic, cultural, and geographical factors that affect ANC adequacy, providing insights that can guide policy decisions and healthcare strategies to improve access and utilization of maternal healthcare. This study examines factors affecting ANC adequacy among 1,915 reproductive-aged women, focusing on those currently pregnant or with prior pregnancies. Cross-sectional data was obtained through a stratified multi-stage sampling using probability proportional to size, as women were interviewed from selected households nationwide between June and August 2022. Data were analysed using descriptive, Pearson Chi-Square, and multinomial logistic regression analyses. Results revealed that while 53.1% accessed some ANC, only 40.5% received adequate care. The main predictors of ANC adequacy included age, region, education, employment, and parity. Further analysis showed that younger adults have a higher likelihood of receiving adequate ANC ( $$\:OR=2.105;95\%\:CI=1.105\:-\:4.010$$ ). Additionally, increased education and employment status were strongly correlated with improved ANC adequacy ( $$\:OR=4.604;95\%\:CI=2.890\:-7.334$$ ). Conversely, increased parity was associated with a decrease in ANC adequacy. ANC adequacy in Nigeria is influenced by many factors; age, education, employment status, regional differences, parity, parents’ parity, pregnancy intentions, and media exposure. Therefore, to improve ANC a better approach focusing on health education and strengthening healthcare in underserved areas is required to enhance maternal and child health outcomes.