Assessment of Antenatal Care Utilisation and Birth Outcomes Among Women in Rural Communities of Kebbi State

Inadequate antenatal care utilisation in rural northern Nigeria is a recognised contributor to poor maternal and neonatal outcomes, yet community-level data from Kebbi State remain scarce. This study assesses antenatal care utilisation patterns and their association with birth outcomes in rural communities of Kebbi State, North West Nigeria. A community-based cross-sectional survey enrolled 250 women who delivered within the preceding 12 months, selected through multistage sampling from five rural local government areas. Structured interviewer-administered questionnaires captured number of antenatal visits, gestational age at first booking, facility of delivery, and neonatal outcomes including birth weight and early neonatal death. Only 34 percent of respondents achieved the WHO-recommended minimum of eight antenatal contacts. Forty-one percent made their first visit after 28 weeks gestation. Women with fewer than four antenatal visits had significantly higher rates of low birth weight neonates (OR 3.4) and perinatal mortality (OR 4.1). Distance to health facility exceeding five kilometres, husband disapproval, and cost of transport were the most frequently cited barriers. The study identifies demand-side and supply-side constraints limiting antenatal uptake in Kebbi's rural belt. Recommendations include community midwifery outreach, male partner engagement programmes, and transportation subsidy schemes coordinated by the Kebbi State Primary Health Care Development Agency to improve antenatal coverage and birth outcomes in the North West zone. Keywords: antenatal care utilisation, birth outcomes, Kebbi State, rural communities, maternal health