Patient and Clinic-Related Predictors of Inconsistent Antenatal Care Use Among Women Attending Care in Awka, South-East Nigeria

Abstract Background: The World Health Organization (WHO) recommends a minimum of eight antenatal clinic visits for safe motherhood. However, women in sub-Saharan Africa (SSA) often miss one or more appointments, elevating their risk for adverse pregnancy outcomes. Objectives: The study is aimed at identifying the predictors of missed antenatal appointments among Nigerian women. Methodology: This study surveyed women receiving antenatal care at three hospitals in Southeastern Nigeria between March 2023 and May 2023, using a validated 25-item, well-structured, self-administered questionnaire. Out of the 400 distributed questionnaires, we retrieved 301. Results: Out of the 301 women surveyed, 115(35%) of them, said that they had missed at least one visit. In the bivariate and multivariate analyses, inconsistent antenatal care use was found to be significantly associated with factors such as advanced age, previous childbirth, higher educational attainment of the partner, receiving care at a government-owned hospital, high registration costs, unfavourable administrative policies, and unsatisfactory attitude of healthcare providers. Conclusion: Pregnancy outcomes remain relatively poor in SSA. This highlights the importance of inter-sectorial collaboration between ministries and stakeholders in developing overarching policies that would promote easy, accessible and affordable antenatal care services in SSA.