Abstract

Daughter Awala Owonaro, Timi Fiekumo Buseri, Owonaro A. Peter*, Buseri Oyintokoni Beauty, Peter Pereotubo Akpe, Micah Ebena, Prosca Seimiegha Levi Owonaro, Ibegi Ibegi Saviour

ABSTRACT

Background: Effective antenatal care (ANC) delivery in primary healthcare (PHC) facilities depends not only on supply-side service availability but on the interplay of facilitators that draw women into care and barriers that keep them away. In the Niger Delta, where riverine geography, road infrastructure deficits, and intermittent electricity supply compound the operational challenges of PHC, this interplay is particularly acute. Pharmacists and other PHC professionals have a direct stake in understanding it. Objective: To identify and characterise the facilitators and barriers to ANC utilisation among recent mothers attending PHC facilities in Yenagoa, Bayelsa State, with attention to the implications for social pharmacy and PHC service-delivery reform. Methods: A community-based cross-sectional study was conducted among 302 recent mothers in twelve communities across six wards in Yenagoa Local Government Area, using a four-stage multistage sampling design. Data on facilitators and barriers to ANC utilisation were collected through a pre-tested, interviewer-administered structured questionnaire. Descriptive statistics were used to summarise the relative frequency of each factor, and the principal patterns were interpreted with reference to the published Niger Delta and West African evidence base. Results: The principal facilitators of ANC utilisation reported were: the provision of information and services for a healthy pregnancy (23.2%), early detection of pregnancy complications (21.5%), reduction of maternal and neonatal morbidity and mortality (20.5%), and emotional support from providers, peers, and accompanying family members (27.5%). The principal barriers were: travel time to the nearest facility exceeding 30 minutes (35.4%), transportation costs exceeding ?300 per trip (21.9%), poor road condition (17.9%), lack of reliable transportation (7.6%), absent prior knowledge of ANC services (7.0%), and adherence to cultural practices including herbal medication and geophagy (4.6%). At the health-system level, 88.4% of respondents identified service quality and 65.6% identified provider attitude as determining factors. The convergent picture is one in which structural-geographic and provider-behavioural barriers, rather than information deficits, dominate the non-utilisation profile. Conclusion: Non-utilisation of ANC at PHC level in the Niger Delta is driven primarily by structural-geographic and provider-behavioural factors rather than by absent maternal awareness. Interventions should therefore focus on the supply side of the system — including transportation support, road infrastructure investment, respectful-maternity-care training of PHC personnel, integration of pharmacists into ANC service delivery, and constructive engagement with traditional birth attendants — rather than investment in awareness campaigns alone.

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