Evaluation of antenatal care utilization studies in Nigeria from 1990-2020: A narrative review

Background: In Nigeria and other developing countries, there are still recorded high cases of maternal and perinatal mortality rates which can be attributed to the general under utilization of antenatal care (ANC) services which varies across variables. Antenatal care still remains the proven approach targeted to improving the quality and efficacy of ANC and also improving the overall health outcome of mother and child. The new model recommends a minimum of 8 contacts during the entire course of a woman's pregnancy in order to reduce drastically incidences of maternal and perinatal mortality and to also enhance the woman's experience of care during pregnancy. Objective: This study presented an overview of Antenatal Care Service Utilization Studies and Services in Nigeria and generated information for intervention and policy making. Methods: This study reviewed an overview of antenatal care services and its utilization in Nigeria imploring the use of a narrative review style literature writing. The literature search was conducted on computerized databases. Search terms were used singly, in combination, and truncation to select and synthesize articles. The studies selected included those written in the English Language that was carried out in Nigeria with clear study design and properly stated year of publication which fell within the stated years of 1990 to 2020. The data obtained were subjected to descriptive statistics of frequency and percentage and was also subjected to comparative assessment using the Oxford and Scottish Benchmarks for Study Standard. Results: A total of 54 articles met the criteria and were used for the study. The highest incidence of the articles selected were studied Nation-wide (40.74%). This was followed by the southwest (27.78%). South-south and southeast had the same number of articles selected (9.26%), while the north-central had the highest number (7.41%)of articles sited in the north, with north-east and north-west being (3.70%) and (1.85%) respectively. Only one article on antenatal care services and its utilization was cited before the year 2000 (1.85%) while the highest number of studies (79.63%) which were conducted out between 2011 and 2020. The studies were found to fall within the lower half of the Oxford and Scottish benchmarks for the hierarchy of studies and study standards. Conclusion: Antenatal Care service utilization in Nigeria are still at their teething stage. Most of the incidence of the studies conducted were nation-wide and in southwest. The leading study design carried out were cross-sectional descriptive surveys which fell within the lower half of two standard benchmarks (Oxford and Scottish) for the hierarchy of studies.