Mapping Seasonal Geographical access to Maternal Healthcare in Cross River State Nigeria

Abstract Prenatal care and Basic Emergency Obstetric care (BEmOC) are essential sets of maternal health services which are delivered in the Primary Health Centres (PHCs) across Nigeria. Mapping of seasonal access to maternal health services are rarely considered in health-related studies, though maternal mortality remains a major problem in Nigeria. The objectives of this study are to map maternal population access to Prenatal and BEmOC, and examine its seasonality in Cross River State of Nigeria. The study included 960,361 females of childbearing age (15-49) and 119 governmentmanaged primary health centres (PHCs). Data were sourced from secondary sources, and analysed using Geographical Information System (GIS) techniques. Drive times to PHCs were mapped by seasons, and multiple linear regression model was used to examine the relationship between drive times to the facilities, and socio-environmental factors. The results reveal declining maternal population access to healthcare in the wet season and significant relationship between seasonal drive times to maternal health services and socio-environmental factors. The ratios of access were 12.4 per 100,000 women and 7.0 per 100,000 in the dry wet seasons respectively. Facilities’ access reduced from 100% in the dry season to 43.7% in the wet season. Average drive times in the dry and wet seasons were 41.1 minutes and 57.7 minutes respectively. Maternal population access to essential health services declines in the wet season due to flooding. Concerted effort should be made to increase maternal health care access in the wet season through sustainable planning and research. Keywords: Mapping, Access, Maternal health, Health service.