Poor maternal and child health care utilization in Nigeria: Does partners’ age difference matter? (original) (raw)
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Ife Social Sciences Review, 2017
Poor maternity care uptake (MCU) persists in Nigeria. Evidence shows that this is partly responsible for the country's high maternal mortality ratio of 560 deaths per 100,000 live births and under-five mortality rate of 128 deaths per 1,000 live births. Also, wide gap in partners' age difference (PAD) coupled with lack of control over own health and that of their children persist among women in patriarchal societies, especially Nigeria. Given this situation, this study examined the influence of PAD on MCU in Nigeria. Binary logistic regression analysis was performed on 7023 couples in 2013 Nigeria Demographic and Health Survey data. Results indicated significantly lower odds of utilizing maternal and child health care [i.e. antenatal care (ANC), skilled delivery (SD) and postnatal care (PNC)] among women that were far younger than their partners, relative to much older women. For instance, PAD of 10 years or higher was significantly associated with lower odds of utilizing ANC [Odds ratio (OR):0.75, Confidence Interval (CI):0.60-0.92,p<0.001]; SD [OR:0.58,CI:0.46-0.74,p<0.01], and PNC [OR:0.48,CI:0.38-0.60,p<0.001] compared to women who reported same or older age than their partners. These findings suggest the need for enhancement of women status and gender equality through dissuasion against the scenario of large PAD among couples in Nigeria.
The Effects of Early Marriage on the Utilization of Maternal Health Services in Nigeria
Texila International Journal of Nursing, 2023
Antenatal and delivery care are essential maternal health services (MHS) for survival and wellbeing. Nigeria has the highest global burden of maternal mortality with low utilization antenatal and delivery services. Though early marriage is a strong predictor of early pregnancy and childbirth, it is not clear if it is associated with low use of MHS. This study assessed early marriage as a determinant of poor MHS utilization in Nigeria. This study used data from the 2018 Nigeria Demographic and Health Survey (NDHS) which is based on descriptive cross-sectional survey design. The data was limited to ever married women aged 15-24 years. Data was analyzed using SPSS version 20. This study indicates lower likelihood of women who marry early to use antenatal care (OR=0.25, 95%CI=0.21-0.31), receive minimum 4 ANC (OR=0.22, 95% CI=0.18-0.26), receive iron supplementation (OR=0.38, 95%CI=0.33-0.45) and IPTp for malaria prevention (OR=0.57, 95%CI=0.50-0.66). Conversely, Early marriage was found to be associated with higher likelihood of facility delivery (OR=4.6, 95%CI=4.02-5.26) and lower likelihood of delivery by unskilled attendant (OR=0.31, 95%CI=0.26-0.31). These associations disappear in the adjusted model. Nevertheless, the nuanced analysis showed association in the adjusted odd ratio for use of antenatal care (AOR=0.44, 95%CI=0.20-0.99) and number of antenatal care visits (AOR=0.37, 95%CI=0.14-0.95) among women who married at less than fourteen years. Early marriage below age 14 years negatively affect utilization of MHS. There is the need to strengthen legislation against early marriage below 14 years and address socioeconomic challenges that exacerbate vulnerability.
Women's status within the household as a determinant of maternal health care use in Nigeria
African health sciences, 2015
Although gender inequality is often cited as a barrier to improving maternal health in sub-saharan Africa, there is lack of empirical data on how women's socio-cultural characteristics may influence use of health services in Nigeria. To describe how women's position in the household affects receipt of maternity care services. Secondary data analysis of 10,052 and 4,590 currently married women aged 15 to 49 years from the 2008 Nigerian DHS who receive skilled antenatal and delivery care at least till pregnancy was done. Receipt of skilled delivery care was by 37.9% while, natal care was by 98.4%. Education, residence and wealth index all significantly influenced receipt of maternal health care. Women who were involved in decision making on their own health (aOR=1.97; 95%CI=1.88-2.06) and were employed throughout the year (aOR=1.11; 95%CI=1.01-1.23) were more likely to receive skilled antenatal care, while those who justified physical intimate partner violence were less likely...
African Health Sciences
Background: Nigeria is among the countries with a high number of annual maternal deaths partly due to low utilization of maternal health services (MHS). Objective: This study aimed to explore whether there is an association between women's level of education and the appropriate use of antenatal and delivery services. Method: A quantitative cross-sectional study was used to analyze the Nigerian Demographic and Health Survey (NDHS) data. Information from 33,385 women aged 15-49 years was analyzed using Bivariate Pearson Chi square test and multiple logistic regressions. Results: Education is statistically associated with the number of antenatal clinic visits made (AOR = 3.208; CI 2.875-3.578; p < .0001) and the place of delivery (AOR = 2.009; CI 1.449-2.785; p < .0001) even after controlling for availability of skilled health workers, parity, income, religion, age and distance. Conclusion: A long term investment in girls' education will improve income, interaction with health care providers, level of autonomy to seek and pay for appropriate MHS and ultimately use of MHS and positive pregnancy outcomes.
Intergenerational differences in antenatal care and supervised deliveries in Nigeria
Health & Place, 2011
Objective: To assess whether age cohort influences the likelihood of receiving antenatal care (ANC) and having a supervised delivery, before and after adjusting for other factors. Design: Using data from the 2008 Nigeria Demographic and Health Survey, we grouped women into three distinct cohorts based on their year of birth: the young (1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993), the middle (1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983) and the older (1959)(1960)(1961)(1962)(1963)(1964)(1965)(1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973) cohorts. We applied multilevel logistic regression methods to assess the influence of age cohort on receiving ANC and having a supervised delivery among women (n ¼ 18,028) whose most recent birth occurred anytime in the five years preceding the survey. Results: We identified belonging to the youngest age cohort, rural residence, lack of schooling, higher parity, residence in northern region and poor economic status as determinants of low uptake of ANC and supervised deliveries. Conclusion: Urgent efforts are needed in Nigeria to ensure that young women in particular receive ANC and have supervised deliveries. An agenda promoting a combination of individuals campaigning for change (particularly in northern Nigeria), communities raising awareness among men and women, and governmental and nongovernmental organizations working together to find practical solutions is an indispensable aim for saving the lives of many women and children who are at risk of dying of maternal and child-related diseases.
International Medical Science Research Journal, 2020
More than 33% of Nigerian pregnant women do not use the Antenatal Care service during pregnancy. In 2015, for instance, World Health Organization (WHO) revealed that only 61% of Nigerian pregnant women had attended ANC at least once during their pregnancy period. Only 51% of these women met the WHO standard of a minimum of 4 visits. This ANC rate is, without doubt, lower than the WHO African region average of 77%. The situation in Wushishi and Zungeru communities of Niger State may not be different. Despite the number of health facilities available in these communities, some women of childbearing age do not access antenatal care. Most times, many of them lose their lives during delivery at home, some end up with complications or lose their babies at births. This situation raised concern why pregnant women do not attend antenatal care in health facilities around them? This paper examined the socio-cultural impediments to accessing antenatal care services among reproductive-aged women...
Journal of Basic and Clinical Reproductive Sciences, 2016
Background: Maternal and infant morbidity and mortality are major public health problems in Nigeria. Although it is well-known that appropriate antenatal care (ANC) is important in reducing maternal morbidity and mortality, there is limited information on inequities on ANC seeking pattern among the pregnant women in Nigeria. Aim: The study was designed to explore inequities due to age, education, and socioeconomic status (SES) of women of childbearing age in seeking ANC services in Nigeria. Subjects and Methods: A household survey was conducted in 10 randomly selected villages in Nnewi, Anambra State, SouthEast Nigeria. An interviewer-administered questionnaire was used to collect relevant data from 420 women of childbearing age from the villages. The effects of age, education, SES, and ANC seeking behavior were analyzed. Results: It was found that 61.4% (254/420) of the respondents attended ANC clinic at least 6times. Although most of the respondents sought ANC in formal health, a greater percentage utilized private hospitals/clinics more than public health facilities. Age (P < 0.01), educational level (P < 0.001), and SES (P < 0.01) had statistically significant effects on respondents' antenatal clinic attendance and choice of facilities. The highest SES group was more likely to utilize teaching hospitals and private clinics than other SES groups. Conclusions: There were inequities due to SES, educational level, and age of respondents in the pattern of ANC seeking behavior. These inequities could negate the achievement of millennium development goals (MDGs). Interventions that would address the inequities should be developed and implemented if the health-related MDGs are to be achieved.
International Journal of Environmental Research and Public Health
Nigerian women continue to die in childbirth due to inadequate health services such as antenatal care (ANC). Among other factors, the inadequate receipt or non-use of ANC appears to be associated with the age of women, remoteness, and poor households. This cross-sectional study aimed to compare the factors associated with inadequate receipt of the components and non-use of ANC among pregnant adolescents, and young and older women in Nigeria. Data for this study were from the 2018 Nigeria Demographic and Health Survey (NDHS) and covered a weighted total of 21,911 eligible women. Survey multinomial logistic regression analyses that adjusted for cluster, and survey weights were conducted to examine factors associated with adolescent, young, and older women. Adolescent women reported a higher prevalence of inadequate receipts and non-use of ANC than young and older women. Increased odds of inadequate receipt of the components of ANC were associated with residence in the North–East regio...