TRENDS IN UTILIZATION OF MATERNAL HEALTHCARE SERVICES IN NIGERIA, 1990-2024: EVIDENCE FROM SUCCESSIVE NDHS ROUNDS

Abstract

Maternal mortality remains a critical public health challenge in Nigeria, largely reflecting suboptimal utilisation of essential maternal healthcare services. This study examines long-term trends in the utilisation of antenatal care (ANC) from skilled providers, skilled birth attendance (SBA), and timely postnatal care (PNC) among women of reproductive age in Nigeria, using evidence exclusively from successive rounds of the Nigeria Demographic and Health Survey (NDHS) conducted between 1990 and 2024. Drawing on nationally representative and methodologically comparable survey data, the study synthesises national-level trends and key socio-demographic differentials across more than three decades. Findings indicate modest but uneven progress. Skilled birth attendance increased steadily from 32% in 1990 to 46% in 2023-24, while timely postnatal care rose from 30% in 2008 to 43% in the most recent survey. In contrast, antenatal care from skilled providers showed fluctuations, rising to 67% in 2018 before declining to 63% in 2023-24, suggesting challenges in sustaining earlier gains. Across all survey rounds, pronounced disparities persist by place of residence, geopolitical zone, household wealth, and maternal education. Utilisation rates are consistently higher among urban, wealthier, and better-educated women, and substantially lower in rural areas and in the northern geopolitical zones. The findings demonstrate that national improvements in maternal healthcare utilisation have not translated into equitable access. Despite gradual increases in SBA and PNC, coverage levels remain inadequate to meet thetargets of Sustainable Development Goal 3.1. The study underscores the need for regionally targeted, equity-focused maternal health interventions that strengthen access, continuity, and quality of care, particularly among underserved populations. By relying exclusively on NDHS data, this analysis provides a consistent and policy-relevant evidence base for monitoring progress and informing strategies to reduce maternal mortality in Nigeria.