Regional variations in prevalence and factors associated with maternal healthcare services utilisation in Nigeria

The utilisation of maternal healthcare services remains low in Nigeria despite government efforts to enhance access through the establishment of maternal and child health programs. Nigeria is a multiethnic country, and most national policies and programmes aimed at improving utilisation of maternal healthcare services were erroneously implemented equally across different geopolitical zones with little success. Thus, this study examines regional variations in the prevalence and factors associated with maternal healthcare service utilisation in Nigeria. The 2021 Nigeria Multiple Indicator Cluster Survey (MICS) was employed for the study. A weighted sample size of 25,062 women of reproductive age was analysed using STATA SE Version 17. Descriptive statistics (frequency distribution table and chart) were used to gain an understanding of the characteristics of the study population. Inferential statistics (Pearson’s Chi-square test of association) were performed to establish the association between the socio-demographic characteristics of respondents and maternal healthcare service utilisation. All explanatory variables with significant evidence of no collinearity were selected and used in the multilevel mixed-effects binary logistic regression models to examine the factors influencing regional variation in maternal healthcare service utilisation at a p < 0.05 level of significance. The study found persistently low utilisation of maternal healthcare services (antenatal care, delivery care, and postnatal care services) across all regions, with prevalence rates ranging from 30.24% in the South South to 38.27% in the North West. The odds of utilising maternal healthcare services were significantly higher among women with secondary level of education and above, currently in union, wealthier and who desire more children than their counterparts who are not. For instance, women who have primary, secondary, and tertiary education had higher odds of utilising maternal healthcare services than their counterparts with no formal education. This study provides compelling evidence of low utilisation of maternal healthcare services across Nigeria’s regions. This underscores the imperative for targeted policy interventions for each region. Therefore, a one-size-fits-all approach is unlikely to be effective, and policymakers must consider the distinct characteristics and challenges of each region when designing interventions aimed at improving maternal healthcare service utilisation in Nigeria.