Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Peter B. Anderson


HIV has remained a global public health issue despite efforts to curb the trend; especially in sub-Saharan African countries where more than 50% of those infected are women, creating implications for infant transmission. The purpose of this study was to assess trends in knowledge of prevention of mother-to child transmission (PMTCT) of HIV and use of PMTCT-related maternal health services (measured by antenatal care [ANC] in health facilities, use of HIV counseling and testing [HCT] during ANC, and use of skilled birth attendant at delivery [SBA]); as well as the association between knowledge and use of health services among reproductive aged women in Nigeria. The health belief model was the theoretical framework. Secondary data analysis was done using data from the United Nation Children’s Fund Multiple Indicator Cluster Survey conducted in Nigeria in 2007, 2011, and 2016/2017. Chi square for trend analysis showed progressive decline in the proportion of women who had good knowledge of PMTCT and who used skilled birth attendant at delivery over the three periods (p < 0.05). The proportion of women who accessed ANC at health facilities increased in 2011 but decreased in 2016 (p < 0.05), which was a trend also reflected in the proportion of women who used HCT services. Finally, binary logistic regression showed that knowledge significantly predicted use of HCT during ANC in 2016 (p < 0.05, OR = 1.557, 95% CI [1.330-1.822]) while controlling for age, educational attainment, marital status, and area of residence. Results from this study may be applied through redesigning interventions specifically for women, which could improve engagement with HIV-preventive health services and reduce the rate of infant infection.