Socioeconomic Predictors of Maternal and Child Health Service Utilization Within Rural and Urban Areas in Bayelsa State, Nigeria

Maternal and child health service utilization remains an important public health concern in Nigeria, particularly in rural communities where access to healthcare may be limited. This study assessed socioeconomic predictors of maternal and child health service utilization and rural–urban differences in Bayelsa State, Nigeria. A facility-based cross-sectional study was conducted among 411 women aged 15–49 years attending 14 public primary healthcare facilities. Data were collected using a structured questionnaire and analysed using descriptive statistics and multivariable logistic regression. Results were presented with 95% confidence intervals (CIs), with statistical significance set at p < 0.05. Attendance at eight or more antenatal care visits was higher among urban women (73.20%) than rural women (49.66%). Similarly, facility delivery was higher among urban women (97.46%) than rural women (47.66%), as was timely postnatal care (78.68% and 40.19%, respectively). Immunization coverage was 100.00% in urban areas and 98.60% in rural areas, while growth monitoring and promotion utilization was higher in rural areas (71.50%) than urban areas (59.39%). In adjusted analysis, women with higher socioeconomic status had greater odds of postnatal care utilization (AOR = 14.14, 95% CI: 3.86–51.81; p < 0.001). In rural areas, higher socioeconomic status was associated with early postnatal care (AOR = 14.25, 95% CI: 3.61–56.17; p < 0.001), while in urban areas, it was associated with antenatal care, facility delivery and postnatal care. Women aged 25–29 years (AOR = 5.42, 95% CI: 1.14–25.79; p = 0.034), 35–39 years (AOR = 7.03, 95% CI: 1.09–45.42; p = 0.040) and 40–44 years (AOR = 108.81, 95% CI: 3.01–3932.30; p = 0.010) had higher odds of growth monitoring and promotion utilization than women aged 15–19 years in rural areas. Similar significant associations were observed among urban women aged 25–29, 35–39 and 40–44 years. The findings suggest that socioeconomic inequalities and rural–urban differences affect maternal and child health service utilization, particularly facility delivery and timely postnatal care. Strengthening rural healthcare access and addressing socioeconomic barriers to maternal and child health services may improve equitable utilization in Bayelsa State.