Influence of women’s empowerment indices on the utilization of skilled maternity care: Evidence from rural Nigeria

The recommendation to improve access to maternal health based on the study “Influence of women’s empowerment indices on the utilization of skilled maternity care: Evidence from rural Nigeria” is to implement a composite strategy that targets all women’s empowerment indices. This strategy should focus on changing gender norms that constrain women’s empowerment. By addressing these gender norms, women will have greater control over their sexual and reproductive lives, leading to increased access to skilled antenatal, intrapartum, and postnatal maternity care.

Specifically, the study found that women’s education and their participation in payment for their own health care positively predicted their use of skilled maternal care. Therefore, efforts should be made to improve women’s education and promote their financial independence. Additionally, women who made decisions alone about major household purchases were more likely to use all three levels of services, highlighting the importance of empowering women in decision-making processes.

Religion and a large spousal education gap were identified as strong positive factors, indicating the need to engage religious leaders and promote education for both women and their partners. On the other hand, living in a consensual union rather than being legally married was a negative factor, suggesting the importance of addressing social and cultural barriers that may hinder access to maternal health care for women in non-marital relationships.


1. Data Collection: Conduct a household survey similar to the one described in the study, targeting ever-married women currently in a union who have given birth in the past five years. Collect information on women’s empowerment indices, including education, financial independence, decision-making power, and cultural norms.

2. Variable Selection: Identify and select the relevant variables that align with the women’s empowerment indices mentioned in the study. These variables may include women’s education level, their participation in payment for their own health care, decision-making autonomy, religious affiliation, spousal education gap, and marital status.

3. Data Analysis: Use hierarchical logistic regression analysis to assess the association between the selected women’s empowerment variables and the utilization of skilled antenatal, intrapartum, and postnatal maternity care. This analysis will help determine the likelihood of receiving all three levels of skilled maternal health care services based on the women’s empowerment indices.

4. Intervention Design: Based on the findings from the analysis, design interventions that target the identified areas for improvement. For example, interventions could focus on improving women’s education, promoting financial independence through income-generating activities, empowering women in decision-making processes, engaging religious leaders to promote maternal health, and addressing social and cultural barriers for women in non-marital relationships.

5. Implementation and Evaluation: Implement the interventions in the target population and monitor their impact on improving access to maternal health. Evaluate the effectiveness of the interventions by comparing the utilization of skilled maternal health care services before and after the implementation.

6. Policy Recommendations: Based on the evaluation results, provide policy recommendations to scale up successful interventions and address any remaining barriers to improve access to maternal health care. These recommendations can contribute to achieving the maternal health-related development goals outlined in the Sustainable Development Goals (SDG-3) in Nigeria.

It is important to note that this methodology is a general framework and may require customization based on the specific context and resources available for implementation.