Demand for Women’s Health Services in Northern Nigeria: A Review of the Literature

Abstract

Demand for and utilization of women's health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women's health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region's population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women's health-seeking behaviors for themselves and for their children. Programs seeking to improve women's health outcomes in northern Nigeria should involve women's influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services. RésuméLa demande et l'utilisation des services de santé des femmes dans le nord du Nigeria sont toujours faibles et les indicateurs de santé dans la région sont parmi les plus pauvres du monde. Cette revue de la documentation se concentre sur les obstacles sociaux et culturels à l'utilisation de contraceptifs, les soins prénatals et les naissances dans des établissements dans le nord du Nigéria, et les influences du comportement de recherche de la santé des jeunes femmes. Une recherche approfondie de la documentation grise et évaluée par les pairs a permis d'obtenir 41 publications synthétisées et analysées. La population de la région est majoritairement musulmane, pratiquant l'islam comme toute une mode de vie. Tandis que la société au nord du Nigeria évolue lentement, la plupart des femmes manquent encore d'éducation formelle, avec une proportion importante mariée dans leur adolescence et la majorité n'étant ni socialement ni économiquement habilitée. Le mari prend en grande partie la plupart des décisions du ménage, y compris l'utilisation des services de santé par les membres de son ménage. Ces pratiques influent directement sur les comportements de recherche de la santé des femmes pour eux-mêmes et pour leurs enfants. Les programmes visant à améliorer les résultats de la santé des femmes dans le nord du Nigeria devraient impliquer les gens qui influencent des femmes pour affecter le changement de comportement, y compris les maris, les chefs religieux et d'autres. De plus amples recherches sont nécessaires pour identifier les voies d'information qui peuvent être utilisées par des programmes conçus pour accroître la demande de services de santé dans la région. (Afr J Reprod Health 2017;...

Addressing socio-cultural barriers to family planning and co-designing services to improve utilization: evidence from northern Nigeria

“…This conforms with known literature in the study areas and many other parts of Sub-saharan Africa [5][6][7][15][16][17][18]. Similarly, the influence of husbands as major decision makers on whether to use and not to use family planning services from this study also conform with known findings from other studies other parts of Africa [19,20]. While respondents affirmed that there had been increase in use of family planning in their communities, it was obvious that significant use of traditional methods still exist.…”

Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey

“…A previous study has made a similar report in respect of maternal healthcare services utilization among Muslim mothers in Nigeria [ 6 ]. Given that Islam is more prominent in parts of northern regions in Nigeria [ 36 , 38 ], it is likely that the finding of low ANC utilization among Muslim mothers contributed to the regional differences observed in this study, especially in urban residence. Religious obligations which require that Muslim women avoid undue exposure of their bodies have been suggested as the reason for the finding [ 38 , 39 ].…”

“…The present study, therefore, lends credence to previous evidence showing better ANC utilization in South-West and South-East regions in the country [ 4 , 20 , 35 ]. Differences in socioeconomic development, educational attainment and access to healthcare facilities in the various regions may partly explain the disparities observed in this study [ 4 , 36 ]. For example, the South-West region relatively enjoys a greater access to education and healthcare facilities than other regions in the country.…”

“…For example, the South-West region relatively enjoys a greater access to education and healthcare facilities than other regions in the country. On the other hand, the northern regions (North-Central, North-East, and North-West) are educationally and socioeconomically disadvantaged [ 36 ]. Socioeconomic disadvantage occasioned by environmental degradation, infrastructure deficits, and low employment level has equally been reported in the South-South region of the country [ 37 ].…”

Home childbirth among young mothers aged 15–24 years in Nigeria: a national population-based cross-sectional study

“…This comparative advantage may provide greater access to healthcare facilities/services, and subsequently, better use of institutional delivery in the region. Conversely, the North-East and the North-West regions of the country are among the least developed socioeconomically and educationally 8 55. The South-South region equally suffers low socioeconomic development due to a shortfall in infrastructure, environmental degradation and high rates of unemployment 8.…”