ABSTRACT
BACKGROUND: Optimal antenatal care visits and health facility delivery are essentials to save lives of the women and the baby during pregnancy and delivery. Though focused antenatal care visits and health facility delivery is recommended by World Health Organization, Nigeria has sub-optimal antenatal care and lagged facility delivery. Maternal health service utilization could however be affected by many factors including access to health services, governmental commitment, and socio-cultural factors. OBJECTIVES: This study assessed the differences between uptake of antenatal care and health facility delivery in urban and rural health facilities in Edo state Nigeria. METHODOLOGY: A comparative longitudinal study was conducted among 220 pregnant women in the third trimester of pregnancy visiting and residing in selected urban and rural communities in Benin City. Data was collected through the use of pretested, interviewer-administered questionnaires. The questionnaire was divided into five sections, covering; Socio-demographic Characteristics, Knowledge of Antenatal Care Service, Level of Uptake of Antenatal Care, Determinants of Antenatal Care Uptake, and Determinants of Facility Delivery. The ANC card of mothers and index child's road to health record booklet were used to confirm information provided by mother where applicable. Statistical analysis was done using the IBM SPSS version 25 software. Univariate and bivariate analyses were carried out for all variables. Multivariate analysis using binary logistic regression was done to determine the predictors of ANC uptake and facility delivery. The level of significance was set at <0.050. RESULTS: The mean age of respondents was 34.83 ± 8.3 years for urban mothers and 37.96 ± 8.5 years for rural mothers. A significantly higher proportion of urban respondents (97.3%) knew about ANC care services compared to rural respondents (84.5%). In terms of uptake, the level of uptake of ANC services among rural respondents was found to be 87.3% when compared to 94.5% among the urban respondents. Among the rural respondents about 70.0% had previously delivered in a healthcare facility as compared to 79.1% in the urban setting. CONCLUSION: The study found significant disparities in ANC and facility delivery between urban and rural areas. Urban women had higher ANC awareness and uptake due to better healthcare access, education, and media exposure, while rural women faced barriers like limited awareness, financial constraints, and logistical issues, leading to lower ANC use. Education, marital status, and socioeconomic status were key factors, with urban, educated, higher-income women more likely to seek services. Financial barriers affected facility delivery across both groups, with rural women noting distance challenges and urban women highlighting the need for skilled personnel. Keywords: antenatal, rural mothers, urban mothers.
