CHAPTER ONE
INTRODUCTION
Maternal and prenatal health has emerged as the most important issue that determines global and national well being. This is because every individual, family and community is at some point intimately involved in pregnancy and the success of child birth, (World Health Organization 2006). Nigeria has one of the highest maternal mortality rates in the world, with more maternal deaths reported than any other country except India. Each year, as many as 60,000 Nigerian women die due to pregnancy-related complications, making up 10 percent of the world‘s maternal deaths, despite constituting only 2 percent of the world‘s population, (Kalimo, 2005). The WHO (1999) estimates Nigeria‘s maternal mortality ratio at 800 maternal deaths per 100,000 live births. Several factors in Nigeria including acceptability and utilization of health services have been identified as a cause of maternal and prenatal mortality.
In developed countries, utilization of antenatal care facilities has become a routine. Prevalence of utilization is approximately 100 percent, bringing the maternal mortality rate to a- significantly lower level of 0.3 percent per 1000 live births. In developing countries, maternal mortality has been little affected by modem maternity due to poor utilization of these services. In rural Nigeria, the prevalence of utilization is 15 percent. Factors influencing the utilization vary from locality to locality and within the same area, variation does occur but generally, illiteracy, poverty, cultural and religious beliefs and poor access have been identified as factors militating against utilization (Adamu and Salihu, 2002).
Statement of the Problem
In line with World Health Organization guidelines (2006), the Ministry of Health (MOH) recommends that a woman having a normal pregnancy attends at least four antenatal care visits, International Conference on Population and Development (ICPD) in 1994 Views Reproductive Health in a broader Development context (United Nations. 1995). Under the safe motherhood initiative, all pregnant women are expected to receive basic antenatal care. The package includes monitoring pregnancies for signs of complications, treating concurrent problems of pregnancy, providing iron supplements, tetanus toxoid immunization and counseling on preventive care and related issues. The purposes of providing such services was to identify signs of, or risk factors for, complicated pregnancies and identify the appropriate health provider (Vanneste and others, 2000; Magadi, Madise and Rodrigues, 2000; Matthews and others, 2001).
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