Inequity in Maternal and Child Health Care Utilization in Nigeria

Nghargbu, Rifkatu; Olaniyan, Olanrewaju

doi:10.1111/1467-8268.12301

Cited by 19 publications

(32 citation statements)

References 35 publications

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“…The later findings are similar to earlier studies that show pro-rich inequalities in maternal healthcare utilization in Ghana [39] and Nigeria [40]. These results provide important evidence that may assist the health stakeholders to redouble their efforts toward achieving the Sustainable Development Goals (SDGs) three targets of reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 [41].…”

Section: Discussionsupporting

confidence: 86%

“…This is not surprising because of the wide gap in socio-economic development between the northern and southern parts of the country [ 10 ]. Studies by Obiyan and Kumar [ 5 ] and Nghargbu and Olaniyan [ 40 ] also emphasized that wealth status and education were the major factors driving inequality in maternal healthcare utilization in Nigeria. Nghargbu and Olaniyan [ 40 ], shows that SES rather than the need for healthcare mainly determine demand for maternal healthcare.…”

Section: Discussionmentioning

confidence: 99%

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Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

Okoli

Hajizadeh

Rahman

et al. 2020

BMC Health Serv Res

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Background Maternal mortality has remained a challenge in many low-income countries, especially in Africa and in Nigeria in particular. This study examines the geographical and socioeconomic inequalities in maternal healthcare utilization in Nigeria over the period between 2003 and 2017. Methods The study used four rounds of Nigeria Demographic Health Surveys (DHS, 2003, 2008, 2013, and 2018) for women aged 15–49 years old. The rate ratios and differences (RR and RD) were used to measure differences between urban and rural areas in terms of the utilization of the three maternal healthcare services including antenatal care (ANC), facility-based delivery (FBD), and skilled-birth attendance (SBA). The Theil index (T), between-group variance (BGV) were used to measure relative and absolute inequalities in the utilization of maternal healthcare across the six geopolitical zones in Nigeria. The relative and absolute concentration index (RC and AC) were used to measure education-and wealth-related inequalities in the utilization of maternal healthcare services. Results The RD shows that the gap in the utilization of FBD between urban and rural areas significantly increased by 0.3% per year over the study period. The Theil index suggests a decline in relative inequalities in ANC and FBD across the six geopolitical zones by 7, and 1.8% per year, respectively. The BGV results do not suggest any changes in absolute inequalities in ANC, FBD, and SBA utilization across the geopolitical zones over time. The results of the RC and the AC suggest a persistently higher concentration of maternal healthcare use among well-educated and wealthier mothers in Nigeria over the study period. Conclusion We found that the utilization of maternal healthcare is lower among poorer and less-educated women, as well as those living in rural areas and North West and North East geopolitical zones. Thus, the focus should be on implementing strategies that increase the uptake of maternal healthcare services among these groups.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

Okoli

Hajizadeh

Rahman

et al. 2020

BMC Health Serv Res

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“…19 Our study findings were also comparable with the findings reported in Bangladesh and other similar settings which showed the key reproductive and maternal health services were concentrated among wealthier, more educated, and women from urban areas. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][33][34][35][36] There is inter-regional disparity in the uptake of maternal health services worldwide, with the highest disparity being in Africa and Asia regions. This has huge implications in progress towards attaining SDG targets related to maternal health.…”

Section: Discussionmentioning

confidence: 99%

<p>Inequities in the Uptake of Reproductive and Maternal Health Services in the Biggest Regional State of Ethiopia: Too Far from “Leaving No One Behind”</p>

Daka¹,

Woldie²,

Ergiba³

et al. 2020

CEOR

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Background: Despite improvement in the coverage of most maternal, newborn, and child health services, inequality in the uptake of services still remains the challenge of health systems in most developing countries. This study was conducted to examine the degree of inequities and potential predictors of inequity in reproductive and maternal health services utilization in the Oromia region, Ethiopia. Methods: The 2016 Ethiopian demographic and health survey data set was used. Utilization rate of four maternal health service categories (family planning, antenatal care, facility based delivery and postnatal care) was considered in the analysis. Equity in each of these indicators was assessed by residence (urban/rural), wealth index, and educational status. Inequality in service utilization was estimated using rate ratios, concentration curve, and concentration indices. Results: Overall data of 5701 women were used in this analysis. The concentration index to all of the maternal health service utilization indicators showed significance. The concentration index of family planning, antenatal care, facility based delivery, and postnatal care was 0.136 (95% CI=0.099-0.173), 0.106 (95% CI=0.035-0.177), 0.348 (95% CI=0.279-0.418), and 0.348 (95% CI=0.279-0.418), respectively. Maternal age and all of the three sociodemographic factors (residence, education, and wealth) showed inequitable distribution of maternal health service utilization in the Oromia region. The majority of women who were in the favored groups utilized the key reproductive and maternal health services. Conclusion: The utilization of maternal health services in the study area is grossly skewed to those who are well off, educated, and live in urban areas. Any action intended to improve utilization of maternal and child health services should aim to reduce the unnecessary and avoidable disparity demonstrated in our analysis. This of course demands multisectoral intervention to impact on the determinants.

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“…Moreover, the study communicates that it is equally relevant for other platforms to become fully engaged in the same way if MHSs are to be widely disseminated to adolescents. Indeed, accessibility to MHSs is important in increasing awareness, persuading and reminding pregnant mothers from seeking and getting devoted to seeking health services (6). Overall, the findings indicate that maternal health care services are still low in Uganda.…”

Section: Strategies For Improving Access To Maternal Health Servicementioning

confidence: 86%

Maternal health services for pregnant adolescent girls in Uganda: Barriers and Opportunities

Namuli

Chinkonono

Atuhaire

et al. 2020

Preprint

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Background: Globally, adolescent pregnancy is one of the major areas of concern. Over 16 million girls aged between 15-19 years give birth, while over 1 million become pregnant before 15 years, most of who are in Sub-Saharan Africa. Yet, very few adolescents access maternal health services. This study explored the available maternal health services, barriers in accessing them and possible strategies for improving accessibility to these services among pregnant adolescents, specifically in Uganda.Methods: The study was carried out at Naguru teenage information and health Centre (NTIHC), Nakawa division, Kampala district using a qualitative research approach. Data was obtained using in-depth face to face interviews from 31 independent pregnant adolescents and four health care providers. These participants were selected using convenient sampling technique. Data was manually analyzed and themes were extracted and used in the interpretation of results.Results: The study found out that adolescents use only antenatal health care services while the uptake of postpartum health services was side-lined much as they were found available in the health facilities. The dominant antenatal care services among adolescents include; testing and managing of STIs, measuring pressure, tetanus vaccine, measuring weight, counselling and guidance, peer education, and providing drugs. Adolescents also encountered challenges such as long distances, financial constraints, stigmatization, negative attitude of health workers and community expressed bias when accessing these services. It further revealed that through government intervention, community and health workers, accessibility to maternal health services would be improved. Specifically, increasing remuneration for health workers; sensitizing communities about adolescent pregnancy and rights; construction of labour suites; and health workers’ competence were highly emphasized.Conclusion: Advertising and promotion of maternal health services; sensitization of community members; and government involvement will be the key parameters for enhancing maternal health care among adolescent mothers.

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Inequity in Maternal and Child Health Care Utilization in Nigeria

Cited by 19 publications

References 35 publications

Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

<p>Inequities in the Uptake of Reproductive and Maternal Health Services in the Biggest Regional State of Ethiopia: Too Far from “Leaving No One Behind”</p>

Maternal health services for pregnant adolescent girls in Uganda: Barriers and Opportunities

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