As the world draws curtains on the implementation of Millennium
Development Goals (MDGs), there is increasing interest in evaluating the
performance of countries on the goals and assessing related challenges
and opportunities to inform the upcoming Sustainable Development
Goals (SDGs). This study examined changes in the timing and utilisation
of maternal health care services in Nigeria and Malawi; using multivariate
negative log–log and logistic regression models fitted to demographic
and health survey data sets. Predicted probabilities were also computed
to observe the net differences in the likelihood of both the first and the
required number of antenatal care (ANC) visits for each of the three
analysis years. Women in Nigeria were 7% less likely in 2008 compared
to 2003, and in Malawi, 32% more likely in 2013 compared to 2000, to
utilise ANC in the first trimester of pregnancy. Timing of first ANC visit
was strongly influenced by wealth in Nigeria but not in Malawi. The
findings in our case studies show how various contextual factors may
enable or inhibit policy performance. Maternal and child health, SDGs
should incorporate both wealth and degrees of urbanicity into country
level implementation strategies.