Factors Associated with Access to Maternal Health Services in Primary Health Care Centers in Karu Local Government Area of Nasarawa State, Nigeria

Background: Despite progress, access to maternal health services remains a challenge in sub-Saharan Africa, where only 56% of births occur in health facilities. Understanding local determinants of access is essential for improving maternal and child health outcomes. Objective: This study assessed factors influencing access to primary health care (PHC) services among pregnant women in Karu Local Government Area (LGA), Nasarawa State, Nigeria, and examined their relationship with child mortality. Methods: A descriptive cross-sectional study employing a mixed-method approach was conducted. Quantitative data were collected from 355 mothers using structured questionnaires, while qualitative insights were obtained through in-depth interviews. A multi-stage sampling technique selected respondents from three wards (Karshi II, Uke, and Karu). Data were analysed using SPSS with chi-square tests and binary logistic regression. Results: Overall, 75% of mothers reported access to PHC services, with Karu ward recording the highest utilisation (69.9%). Socio-demographic characteristics significantly associated with access included ward (?2 =14.999, p=0.001), religion (LR =14.368, p=0.003), and husband’s income (?2=22.568, p=0.000). Waiting time emerged as the most significant barrier to access (?² = 4.069, p = 0.044). Child mortality was significantly associated with ward (?2=11.522, p=0.003), mother’s occupation (LR=13.306, p=0.038), mother’s age (LR=13.156, p=0.011), duration of PHC access (?2=13.791, p=0.008), and husband’s income (?2=12.103, p=0.033). Notably, 85.8% of respondents with good PHC access reported reduced child mortality (p=0.006). Conclusion: Access to PHC services in Karu LGA is relatively high, and improved access is significantly associated with reduced child mortality. Targeted interventions addressing waiting times and socio-economic disparities could further enhance service utilisation and maternal-child health outcomes.