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

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Study Justification:
The study aims to investigate the relationship between women’s empowerment indices and the utilization of skilled maternity care in rural Nigeria. This is important because previous research has shown that empowered women have better access to maternal health services, leading to reduced maternal morbidity and mortality. By understanding the factors that influence women’s utilization of skilled maternity care, policymakers can develop targeted interventions to improve maternal health outcomes in Nigeria.
Highlights:
– The study used data from a household survey conducted in two rural Local Government Areas in Edo State, Nigeria.
– The sample included 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.
– Hierarchical logistic regression analysis was used to assess the association between women’s empowerment variables and the utilization of skilled antenatal, intrapartum, and postnatal maternity care.
– 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. However, land ownership negatively predicted utilization.
– Decision-making variables also played a role, with women who made decisions alone about major household purchases being more likely to use all three levels of services. On the other hand, women making decisions alone about daily food preparation were less likely to utilize skilled maternity care.
– Influencer variables such as religion and a large spousal education gap were found to be strong positive factors, while being in a consensual union rather than a legal marriage was a negative factor.
– The study highlights the importance of interventions that address gender norms and empower women to improve maternal health outcomes in Nigeria.
Recommendations:
– The study recommends a composite strategy that targets all women’s empowerment indices to improve maternal health outcomes in Nigeria.
– Policymakers should focus on interventions that aim to change gender norms and empower women, in addition to addressing health system factors.
– By implementing interventions that promote women’s education, increase their participation in decision-making, and reduce gender disparities, Nigeria can work towards achieving Sustainable Development Goal 3, which focuses on good health and well-being.
Key Role Players:
– Ministry of Health: Responsible for implementing and coordinating interventions related to maternal health.
– Non-governmental Organizations (NGOs): Organizations that can provide support and resources for implementing women’s empowerment programs.
– Community Leaders: Key influencers who can help promote and support women’s empowerment initiatives at the local level.
– Health Care Providers: Involved in delivering skilled maternity care services and can play a role in promoting women’s empowerment.
Cost Items for Planning Recommendations:
– Education Programs: Budget for implementing educational programs that target women’s empowerment, including literacy and vocational training.
– Awareness Campaigns: Funds for conducting awareness campaigns to promote women’s rights and gender equality.
– Capacity Building: Resources for training healthcare providers and community leaders on gender-sensitive approaches and women’s empowerment.
– Infrastructure Development: Budget for improving healthcare facilities and ensuring access to skilled maternity care services.
– Monitoring and Evaluation: Funds for monitoring and evaluating the effectiveness of interventions and making necessary adjustments.
Please note that the cost items provided are general categories and not actual cost estimates. The specific budget items would need to be determined based on the context and scale of the interventions.

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.

The study “Influence of women’s empowerment indices on the utilization of skilled maternity care: Evidence from rural Nigeria” recommends implementing a composite strategy to improve access to maternal health. This strategy should focus on addressing gender norms that limit women’s empowerment. By targeting these norms, women will have more control over their sexual and reproductive lives, leading to increased access to skilled maternity care.

The study found that women’s education and their participation in paying for their own healthcare 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 maternity care services. This highlights 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. This suggests the importance of addressing social and cultural barriers that may hinder access to maternal healthcare for women in non-marital relationships.

Overall, the recommendation is to develop and implement a comprehensive strategy that addresses all aspects of women’s empowerment, including education, financial independence, decision-making power, and cultural norms. This approach will contribute to achieving the maternal health-related development goals outlined in the Sustainable Development Goals (SDG-3) in Nigeria.
AI Innovations Description
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.

Overall, the recommendation is to develop and implement a comprehensive strategy that addresses all aspects of women’s empowerment, including education, financial independence, decision-making power, and cultural norms. This approach will contribute to achieving the maternal health-related development goals outlined in the Sustainable Development Goals (SDG-3) in Nigeria.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, a methodology could involve the following steps:

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.

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