Mothers' Healthcare Autonomy, Maternal-Health Utilization and Healthcare for Children under-3 Years: Analysis of the Nigeria DHS Data (2008-2018).

Tolulope Ariyo,Quanbao Jiang

doi:10.3390/ijerph17061816

Abstract

This study was designed to simultaneously examine if mothers’ personal healthcare autonomy within the household, and the level of their maternal-healthcare utilization, translates into better preventive (complete immunization) and curative (treatments for diarrhoea, fever and acute respiratory infection) efforts on morbidities in child healthcare. We analysed data pooled from three consecutive waves of the Nigeria Demographic and Health Survey: the surveys of 2008, 2013 and 2018. Using a multilevel logistic regression, we estimated the odds ratio for each of the outcome variables while adjusting for covariates. Findings revealed that mothers’ health autonomy is positively associated with child immunization and treatment of morbidities (except diarrhoea), a relationship moderated by the frequency of mothers’ exposure to media. Additionally, mothers’ healthcare utilization is positively associated with complete immunization, and all forms of morbidity treatment (except diarrhoea). Although the relationship between mothers’ healthcare-utilization and child immunization is not dependent on family wealth, however, the relationship between mothers’ healthcare utilization and treatment of morbidity is dependent. Policy effort should be geared towards stimulating mothers to seek appropriate and timely child healthcare and future studies could consider looking into the mediating role of paternal support in this relationship.

Highlights

In 2018, a global estimate of 5.3 million children under the age of five years died mainly from various forms of curable morbidities, the highest proportion being among the countries of sub-Saharan Africa (SSA)
The Nigeria Demographic and Health Survey (NDHS) shows that risk of under-five mortality is higher among children from poor and non-educated families [3]
16.4% are first-born children and just 2.0% were delivered through a caesarian section

Summary

Introduction

In 2018, a global estimate of 5.3 million children under the age of five years died mainly from various forms of curable morbidities, the highest proportion being among the countries of sub-Saharan Africa (SSA). The Nigeria Demographic and Health Survey (NDHS) shows that risk of under-five mortality is higher among children from poor and non-educated families [3]. Treatment of childhood illnesses such as diarrhoea, fever and acute respiratory infection (ARI) are usually very effective if the care is sought on time, but a large number of children who are morbid die without ever accessing healthcare facilities [6] This is partly due to inability to recognize potentially life threatening conditions [6], and the availability of cheaper alternative in traditional medicine which in some cases may not be as effective, especially when diarrhoea, fever and ARI are mere symptoms of other undiagnosed severe illness [7]

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Conclusion