Influence of women’s empowerment indices on the utilization of skilled maternity care

Evidence from rural Nigeria

Bibliographic Data

ID21342527
AuthorsLorretta Ntoimo (0000-0002-3218-5535, Social Action, corresponding author), Friday E Okonofua (University of Benin Teaching Hospital), Josephine Aikpitanyi (University of Benin), Sanni Yaya (0000-0002-4876-6043, University of Ottawa), Ermel Johnson (West African Health Organisation), Issiaka Sombie (0000-0001-9435-7198, West African Health Organisation), Olabisi Aina (Obafemi Awolowo University), Wilson Imongan (0000-0001-7734-0626, Federal University Oye Ekiti)
Year2022
Volume54
Issue1
Pages77-93
Publication date2022-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Biosocial Science (JOURNAL)
Journal identifiersISSN: 0021-9320 • E-ISSN: 1469-7599
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0021932020000681
PMID33261675
OpenAlexW3108490605
LanguageEN
Citations received6
References cited52

There is increasing evidence that women with the ability to exercise control over their sexual and reproductive lives have greater access to prompt prevention and treatment of maternal health disorders, resulting in a concomitant reduction in maternal morbidity and mortality. This study assessed the association between indices of women’s empowerment and utilization of skilled antenatal, intrapartum and postnatal maternity care in two rural Local Government Areas in Edo State, Nigeria. Data were taken from a household survey conducted in July and August 2017, and the study sample comprised 1245 ever-married women currently in a union who had given birth in the 5 years preceding the survey. A Gender Roles Framework guided the selection of independent women’s empowerment variables. Using hierarchical logistic regression, the likelihood of receiving all three levels of skilled maternal health care service (antenatal, intrapartum and postnatal) by women’s empowerment variables, grouped into resource, decision-making and influencer domains following the model of Anderson and Neuman, was assessed. Of the resource domain variables, respondent’s education and respondent’s participation in payment for their own health care positively predicted their use of all three levels of skilled maternal care, whereas their ownership of land negatively predicted this. Two decision-making domain variables were significantly associated with respondent’s use of all three levels of service: those who made decisions alone about major household purchases were twice as likely to use all three levels of services than when decisions were made by their partners or others, while respondent making decisions alone about what food to cook each day was a negative predictor. Of the influencer variables, religion and a large spousal education gap were strong positive factors, whereas living in a consensual union rather than being legally married was a negative factor. Although health system factors are important, interventions geared towards changing gender norms that constrain women’s empowerment are critical to achieving maternal health-related development goals in Nigeria. A composite strategy that targets all women’s empowerment indices is recommended, as Nigeria strives towards achieving SDG-3

Empowerment · Government (linguistics) · Health care · Maternity care · Prenatal care · Reproductive health · Respondent · Sample (material) · Women's empowerment · Child Nutrition and Water Access · Gestational Diabetes Research and Management · Global Maternal and Child Health