Covariates of Maternal Health Care Utilization: Evidence from Agricultural Households in Rural Nigeria

Abstract

Maternal health care utilization remains a persistent public health concern in Nigeria, particularly in rural areas where maternal mortality rates are among the highest globally. This study investigates the socio-economic and demographic covariates influencing maternal health care utilization among agricultural households in rural Nigeria. Using data from the 2018 Nigeria Demographic and Health Survey (NDHS), the analysis focused on 2,751 women in agricultural households, employing a Tobit regression model. The findings reveal that maternal health care utilization is significantly influenced by factors such as mother’s education, age at first birth, employment type, media exposure, household head’s sex, regional location, and birth order. Contrary to prior studies, the study found that formal education, media exposure, and full-time engagement in agriculture were negatively associated with maternal health care utilization, suggesting underlying sociocultural barriers. For instance, religious and patriarchal norms in some northern regions were noted to limit women’s autonomy in health-seeking decisions. The study also affirms regional disparities, with women in the South-East and South-West zones less likely to utilize maternal care compared to those in the North-Central zone. The study concludes that maternal health care utilization in rural agricultural households is shaped by intersecting social, economic, and cultural factors. Addressing these determinants is vital for improving health outcomes and enhancing household productivity in Nigeria’s rural economy. The results underscore the need for multi-sectoral policy approaches that promote female education, delay early marriage, improve healthcare infrastructure in rural areas, and economically empower women. Additionally, targeted media campaigns and male involvement in maternal health decisions are crucial for fostering behavioral change and boosting service uptake. Addressing these barriers is crucial not only for improving maternal health but also for enhancing agricultural productivity and reducing rural poverty in Nigeria