Socioeconomic Inequalities and Informational Determinants of Antenatal Care Utilisation in Nigeria

Abstract

Background Nigeria continues to record one of the highest maternal mortality ratios globally, with persistent inequalities in access to maternal health services. While mass media and digital technologies are increasingly recognised as essential channels for health promotion, evidence on their role in maternal healthcare utilisation in Nigeria remains limited. This study examined the influence of media exposure, technology access, and socio-economic factors on antenatal care utilisation among Nigerian women of reproductive age. Methods Data were drawn from the 2021 Nigeria Multiple Indicator Cluster Survey (MICS), a nationally representative survey. The analytic sample included 10,007 women aged 15–49 years who had given birth within the reference period. Descriptive statistics were used to summarise socio-demographic characteristics. Analysis of variance (ANOVA) was used to test associations between independent variables and antenatal care utilisation. Logistic regression models estimated the adjusted effects of education, wealth, media exposure, technology access, and geographic factors on the uptake of antenatal care. Correlation analysis further examined the relationships between demographic and informational variables. Results Antenatal care utilisation was strongly associated with education, household wealth, and place of residence. Women with higher education and those in the richest wealth quintile were significantly more likely to access antenatal care, while rural and less-educated women were disadvantaged. Media exposure (radio, television, newspapers) was positively associated with antenatal care, with regular use of radio and television showing the most potent effects. Digital access emerged as an essential determinant: mobile phone ownership (49% of women) and internet use (11%) were strongly linked to increased utilisation of antenatal care. Regional disparities were evident, with women in northern zones less likely to access care compared to those in southern zones. Conclusion Both structural and informational determinants shape the utilisation of antenatal care in Nigeria. Socioeconomic inequalities, rural–urban divides, and regional differences remain substantial barriers, while access to media and technology offers critical opportunities to improve maternal healthcare uptake. Policies aimed at reducing maternal mortality should combine strategies to alleviate socioeconomic disadvantage with efforts to harness mass media and digital platforms for maternal health promotion.