Maternal health care in Nigeria: Do community factors moderate the effects of individual-level Education and Ethnic origin?

Maternal mortality ratio in Nigeria is still high despite the initiation of the safe motherhood initiative. The poor maternal health situation has been attributed to inadequate use of maternal health care services. This study examines whether community factors moderated the association between individual factors and the use of skilled ANC. Data on 17560 women aged 15-49 years drawn from 2008 Nigeria Demographic and Health Survey were used. Multilevel logistic regression models were used for analysis. Results reveal variations in the use of skilled ANC across the Northern and Southern regions. Residence in communities with a high proportion of women that delivered in a health facility increased the odds of skilled ANC utilization. Community education and poverty moderated the association between individual factors and the utilization of skilled ANC. To improve the use of ANC and increase the pace towards achieving the sustainable Development Goal-improved maternal health in the post 2015 era, increasing health facility delivery, women’s education and targeting poverty alleviation programs in disadvantaged communities should be taken into consideration.