The Use of Maternal Health Services in Nigeria: Does Ethnicity and Religious Beliefs Matter?

Abstract

The social environment is known to influence our attitudes and behavior in all spheres of life including the utilization of maternal health services (MHS). This study was aimed to determine whether Nigerian women’s cultural profile measured by ethnicity and religious beliefs is significantly associated with the use of antenatal care (ANC) and delivery services. A secondary data analysis of the Nigerian Demographic and Health Survey (DHS) was used to explore whether the ethnicity and religious affiliations of women influence the use of ANC and delivery services. A total of 33,385 women (15–49years) were randomly selected using a stratified two stage cluster sampling from 286 and 602 urban and rural clusters respectively from the 36 states and the Federal Capital Territory (FCT) proportionate to population size of each cluster. Christians have higher proportion of women that had 4 or more ANC visits (28.2%) compared to women belonging to Islamic faith (21.6%). A woman’s religious beliefs was found to be statistically associated with the number of ANC visits (χ2= 189.956df=2; p .05). The odds of a Yoruba woman (South west) giving birth in a health facility is 35 folds compared to a Hausa woman (UOR=34.817; CI 30.233–40.097), followed by Igala in the North central (UOR=29.723; CI 21.509–41.076) and Igbo in the south east (UOR=26.562; CI 23.035–30.63) This association remained statistically significant even after controlling for confounding. This study ethnicity and religious beliefs to a lesser extent have influenced the use of ANC and delivery services in Nigeria. Policy makers should consider systematic and deliberate involvement of tribal and religious leaders when formulating strategies to reach ethnic nationalities.