Exploring hidden barriers to maternal and child health in low resource communities of Keffi Nasarawa State using a mixed methods approach

Abstract Background Maternal and child health (MCH) service utilization is a critical determinant of improved health outcomes, yet disparities in access and use persist in many low- and middle-income settings. This study examined barriers to maternal and child health service utilization among women in Keffi Local Government Area, Nasarawa State, Nigeria. Methods A mixed-methods cross-sectional study design was employed. Quantitative data were collected from 422 women of reproductive age using structured questionnaires, while qualitative data were obtained through focus group discussions and key informant interviews. A multistage sampling technique was used to select participants across six wards. Quantitative data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression, while qualitative data were analyzed thematically. Results Overall, 48.6% of respondents demonstrated high utilization of MCH services, while 51.4% had low utilization. Education (aOR = 2.4; 95% CI: 1.5–3.8), household income (aOR = 1.9; 95% CI: 1.2–3.1), and distance to health facility (aOR = 0.6; 95% CI: 0.4–0.9) were significant predictors of utilization. Qualitative findings identified financial constraints, sociocultural norms, geographic barriers, and health system challenges as key barriers. Conclusion Maternal and child health service utilization remains suboptimal and is influenced by multiple interrelated barriers. Addressing these barriers requires coordinated interventions targeting socioeconomic, geographic, and health system factors.