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  • Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a numberof countries in sub-Saharan Africa, such as Nigeria, is low. Although several studies have identifiedthe determinants and factors associated with ANC services utilization in Nigeria, there is a gap inknowledge about the spatial patterns in ANC use. Therefore, this study aims to map the spatialdistribution and factors associated with ANC visits in Nigeria. A cross-sectional dataset was obtainedfrom the 2018 Nigeria Demographic and Health Survey. A total of 20,003 women aged 15–49 wereconsidered in this study. Both spatial and multilevel analyses were carried out. The results werepresented in spatial maps and adjusted odds ratios (aOR) at a 95% confidence interval (CI). Hotspot areas (high proportion of an incomplete ANC visit) were located in Sokoto, Kebbi, Zamfara,Katsina, Kano, Jigawa, Bauchi, Niger, Borno, Gombe, and Bayelsa. Regional disparities in incompleteANC visits were found in this study. Maternal age, maternal education, partner ’s level of education,working status, ethnicity, parity, religion, exposure to media, place of residence, wealth index, region,and community literacy level were factors associated with incomplete ANC. There is a need toconsider these factors in the design and strengthening of existing interventions (e.g., mini-clinics)aimed at increasing ANC visits to help attain maternal health-related Sustainable Development Goalsby 2030. The regional disparities in incomplete ANC visits also need to be considered by encouragingpregnant women in hotspot areas to attend ANC visits.
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