Exponential Mean Treatment Effect Model of the Impact of Maternal Education on Intensity and Timeliness of Antenatal Care Utilization in Nigeria

Abstract

Inadequate access to antenatal care (ANC) services is a public health problem that is promoting maternal and child mortality in many developing countries. In Niger, utilization of ANC services is a fundamental requirement for achieving some targets in the Sustainable Development Goals (SDGs). The study analyzed the impact of maternal education on the intensity and timeliness of ANC utilization. The data were from the 2021 Malaria Indicator Survey (MIS) and were analyzed with exponential mean treatment effects model. The results showed that 68.66% of the women attended ANC three or four times, while 48.58% did not visit health centres for up to four times. Only 27.09% attended ANC during the first trimester of their pregnancies. The exponential mean model showed that the expected mean of ANC visits significantly increased with women’s age, education levels, urban residence, listening to radio, wealth index and use of Fasidar medication. Moreover, the expected mean of pregnancy month before seeking ANC declined with women’s age, education levels, and wealth index. The average treatment effects (ATE) and average treatment effects on the treated (ATET) were positive for ANC utilization intensity and negative for utilization timeliness. It was recommended that efforts to promote ANC utilization in Niger should promote maternal education through media programmes, manage malaria and create awareness on the minimum required ANC visits for optimum management of maternal and child’s health.