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

Okoli, Chijioke and Hajizadeh, Mohammad and Rahman, Mohammad Mafizur and Khanam, Rasheda ORCID: https://orcid.org/0000-0003-1130-2357 (2020) Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017. BMC Health Services Research, 20:849. pp. 1-14.

[img]
Preview
Text (Published Version)
Okoli_et_al-2020-BMC_Health_Services_Research.pdf
Available under License Creative Commons Attribution 4.0.

Download (837kB) | Preview

Abstract

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.


Statistics for USQ ePrint 39549
Statistics for this ePrint Item
Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Commerce (1 Jul 2013 - 17 Jan 2021)
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Commerce (1 Jul 2013 - 17 Jan 2021)
Date Deposited: 14 Sep 2020 04:15
Last Modified: 30 Sep 2020 03:12
Uncontrolled Keywords: Geographical inequalities, socioeconomic inequalities, Maternal healthcare, Nigeria
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
14 Economics > 1402 Applied Economics > 140208 Health Economics
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111709 Health Care Administration
Socio-Economic Objectives (2008): C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Women's Health
C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health
C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health
Identification Number or DOI: https://doi.org/10.1186/s12913-020-05700-w
URI: http://eprints.usq.edu.au/id/eprint/39549

Actions (login required)

View Item Archive Repository Staff Only