Factors Associated with Antenatal Care Non-Utilisation Among Women in Conflict-Affected Communities in Borno State: Health Education Implications

Antenatal care utilisation is severely disrupted in conflict-affected communities in Nigeria's North East, leaving pregnant women without essential preventive and monitoring services. This study identified factors associated with antenatal care non-utilisation among women in conflict-affected communities in Borno State and discussed the health education implications of the findings. A cross-sectional analytical design was employed, with 320 postpartum women recruited from primary healthcare centres and internally displaced persons camps in Maiduguri, Dikwa, and Gwoza local government areas. A structured interviewer-administered questionnaire was used for data collection. Logistic regression was applied to identify predictors of antenatal care non-utilisation. Results showed that displacement from usual residence (adjusted odds ratio 4.1), fear of insecurity while travelling to facilities (3.8), inadequate knowledge of antenatal care benefits (2.7), and absence of female health workers (2.4) were the strongest predictors of non-utilisation. Trust in traditional birth attendants also significantly deterred formal antenatal care. The study recommends context-sensitive health education strategies including mobile antenatal outreach, radio-based maternal health messaging, and community health education through trusted local intermediaries in conflict-affected Borno State. Keywords: antenatal care, non-utilisation, conflict-affected communities, Borno State, health education