{
  "abstract": "Background: Maternal mortality remains a major public health challenge, particularly in low- and middle-income countries, with Sub-Saharan Africa bearing a disproportionate burden. Nigeria accounts for over one-quarter of all maternal deaths worldwide. This reflects gaps in access to and continuity of maternal healthcare. The continuum of maternal healthcare, which includes antenatal care (ANC), skilled delivery, and postnatal care (PNC) is critical for improving maternal and neonatal outcomes. This study examines the determinants of continuum of maternal healthcare service utilization in Nigeria. Methods: This study utilized data from 13,596 women (weighted n = 14,183) from the 2024 Nigeria Demographic and Health Survey. Maternal Health Services Utilization (MHSU) was operationalized as a composite outcome (none, partial, adequate) based on ANC attendance, place of delivery, maternal and child PNC. Multilevel multinomial logistic regression models were fitted to assess individual, household, and contextual predictors. Variables significant at p < 0.20 in bivariate analysis were included in multivariable models. Statistical significance was set at p < 0.05. Results: Overall, 44.0% of women did not utilize any services, 44.4% partially utilized services, and only 11.6% achieved adequate utilization. Women with secondary or higher education were significantly more likely to achieve adequate utilization (Relative Risk Ratio (RRR) = 12.10, 95% CI: 8.72, 16.81). Wealth status, media exposure, employment, and health insurance were positively associated with utilization, while higher parity and decision-making barriers reduced utilization. Rural residence was associated with lower utilization (RRR = 0.38, 95% CI: 0.29, 0.49). Distance to health facilities was not significant in the adjusted model. Conclusion: Maternal healthcare service utilization in Nigeria remains suboptimal, with significant inequities driven by socioeconomic status, education, and women’s autonomy. Strengthening the continuum of care requires multisectoral interventions addressing structural and social determinants of health.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon",
    "College of Health, Lehigh University, Bethlehem, Pennsylvania, United States of America",
    "Department of Mathematics, Physics and Computing, School of Science and Aerospace Studies, Moi University, Eldoret, Kenya",
    "Usher Institute, University of Edinburgh, Edinburgh, United Kingdom",
    "University of Global Health Equity, Kigali, Rwanda",
    "Malawi Liverpool Wellcome Programme, Infection and Immunity Research Group, Blantyre, Malawi",
    "Department of Economics and Finance, Great Zimbabwe University, Masvingo, Zimbabwe",
    "Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada",
    "Department of Mathematics, Faculty of Science, Muni University, Arua, Uganda"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gideon Ikemdinachi Nwankwo"
    },
    {
      "affs": [
        1
      ],
      "name": "Rejoice Uche Obiora"
    },
    {
      "affs": [
        2
      ],
      "name": "Delight Mawufemor Agbi"
    },
    {
      "affs": [
        3
      ],
      "name": "Bisola Olubiyi"
    },
    {
      "affs": [
        4
      ],
      "name": "Daniel Mumba"
    },
    {
      "affs": [
        5
      ],
      "name": "Herbert Tafadzwa Kazonda"
    },
    {
      "affs": [
        6
      ],
      "name": "Isaac Isiko"
    },
    {
      "affs": [
        7
      ],
      "name": "Edson Mwebesa"
    },
    {
      "affs": [
        8
      ],
      "name": "Charles Natuhamya"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/588hhtk11yk47.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0359946",
  "fulltext_url": null,
  "id": "588hhtk11yk47",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0359946",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Global Maternal and Child Health"
    ],
    [
      "plos",
      "/Biology and life sciences/Neuroscience/Cognitive science/Cognition/Decision making"
    ],
    [
      "plos",
      "/Biology and life sciences/Neuroscience/Cognitive science/Cognitive psychology/Decision making"
    ],
    [
      "plos",
      "/Biology and life sciences/Psychology/Cognitive psychology/Decision making"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health care facilities"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health economics/Health insurance"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Postpartum care/Postnatal care"
    ],
    [
      "plos",
      "/Medicine and health sciences/Women's health/Maternal health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Women's health/Maternal health/Antenatal care"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Africa/Nigeria"
    ],
    [
      "plos",
      "/Social sciences/Economics/Health economics/Health insurance"
    ],
    [
      "plos",
      "/Social sciences/Psychology/Cognitive psychology/Decision making"
    ]
  ],
  "openalex": "W7220367665",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359946&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-05",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/588hhtk11yk47.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0359946",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0359946"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:neuroscience",
      "subfield": "neuroscience"
    },
    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
    },
    {
      "field": "medicine",
      "origin": "plos:women's health",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Determinants of the continuum of maternal healthcare service utilization in Nigeria: Evidence from the 2024 Nigeria Demographic and Health Survey",
  "title_text": "Determinants of the continuum of maternal healthcare service utilization in Nigeria: Evidence from the 2024 Nigeria Demographic and Health Survey",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/588hhtk11yk47",
  "venue": "PLOS One",
  "versions": []
}