Spatiotemporal Patterns and Determinants of Reproductive Health Care Utilization in Nigeria: 2008–2018

Abstract This study examined the spatiotemporal variations and determinants of reproductive health care (RH) indicators in Nigeria- contraceptive prevalence rate, antenatal care by skilled provider, institutional delivery, skilled attendant at birth, and postnatal care, for the period 2008–2018. Data were obtained from Demographic and Health Surveys conducted in 2008, 2013, and 2018. Moran’s I indices and multivariable logistic regression analysis were employed. Wide spatial variations exist in RH utilization at regional, urban/rural and district levels, and among different socio-economic groups. Reproductive healthcare utilization was high in the South-West and South-East zones, urban areas, among women with post-secondary education, richest households, women aged 20–34 years and first birth order but low in the North-West and North-East zones, rural areas, among women with no education, poorest households and those aged 15–19 years. All the RH indicators exhibited a clustered pattern nationally. Locally, hotspot clusters were located in the South-West and South-East while cold spots concentrated in the North-West and North-East zones. Educational level and wealth were the most consistent determinants of utilization of all the RH indicators. Other factors include region, place of residence, partner/husbands educational level and ethnicity. Strengthening of health interventions and educational campaigns are required especially in rural areas.