ArticleBMC pregnancy and childbirth2025
Supply and demand barriers to PHC maternal care services uptake: qualitative and behavioural insights from Gombe State, Nigeria.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Article
- Factors associated with early obstetric ultrasound uptake at a tertiary hospital in Northern Uganda: a cross-sectional study.BMJ open · 2026Article
- Urban-rural disparities in maternal healthcare knowledge, attitudes, and practices among women with a recent live birth in Abuja and Gombe states, Nigeria.Frontiers in public health · 2026Article
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12 authors.
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Abstract
backgroundSeveral factors influence maternal morbidity and mortality in northeast Nigeria, and maternal care-seeking behaviour at primary healthcare facilities is a critical factor. This study, rooted in the Social Ecological Model (SEM) of behaviour change, investigated the structural and demand-side cognitive barriers that limit antenatal and family planning care-seeking behaviour among households in Gombe State, Nigeria.
methodQualitative in-depth interviews, each lasting 60-70 min, were conducted with 56 respondents, including mothers/expectant mothers (n = 15), their household decision-makers/spouses (n = 16), community leaders (n = 16), and primary healthcare centre (PHC) service providers and volunteers (n = 9). The qualitative instrument was developed and analysed based on four core elements of the SEM: intrapersonal, interpersonal, institutional, and community-level factors of behaviour. The study was conducted in Dukku, a rural local government area (LGA), and Yamaltu Deba, a peri-urban LGA.
resultsThe findings indicate that the direct and indirect costs of care, service quality, and PHC proximity were the main supply-side and institutional-level factors. Most of the demand-side barriers were associated with individual (poor salience), relational (limited spousal support), and community-level (traditional maternal practices) factors of the SEM model. Optimism bias, overconfidence bias, and present bias are some demand-side psychological barriers that impede maternal care uptake. Similarly, supply-side barriers, such as poor quality of care, can significantly undermine individual and community-level demand for PHC-based maternal care.
conclusionThe SEM model offers a comprehensive framework for understanding the complex, multi-layered factors influencing care-seeking behaviours toward antenatal care and family planning. The findings show that although relational and community-level barriers are prominent barriers to care-seeking, they are all interlinked and are fuelled by a broad scope of institutional-level barriers.
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