Abstract

This study examines the relationship between religious affiliation and utilisation of maternal health care services using 2013 Nigeria Demographic and Health Survey data. The outcome variable is utilisation of maternal health care service measured by antenatal care and place of delivery. The explanatory variables were religion and three purposively selected social determinants of health, namely the social gradient, work condition and social exclusion. The chi-square test and multinomial logistic regression were applied. Result show that 50.7% had the recommended 4 or more antenatal care visits; 23.4% and 13.5% respectively utilise public and private sector facilities for their most recent child delivery. The relative risk of having 4 or more antenatal visits reduce by a factor of 0.7863 for Muslim women (p<0.05), and increase by a factor of 5.3806 for women in higher social ladder (p<0.01). Religion should be integrated into the social determinants of health framework. . Keywords: Religion, maternal, health care, utilisation, women, social determinant Résumé Cette étude examine la relation entre l'appartenance religieuse et l'utilisation des services de soins de santé maternelle à l'aide des données de 2013 au Nigeria enquêtes démographiques et sanitaires . La variable de résultat est l'utilisation des services de soins de santé maternelle mesurée par les soins prénatals et lieu de livraison . Les variables explicatives sont la religion et trois déterminants sociaux choisis à dessein de la santé , à savoir le gradient social , condition de travail et l'exclusion sociale . Le test du chi -carré et de régression logistique multinomiale ont été appliquées . Résultat montrent que 50,7 % avaient les 4 ou plusieurs visites prénatales recommandées ; 23,4 % et 13,5 % utilisent respectivement les établissements du secteur public et privé pour leur prestation la plus récente de l'enfant . Le risque relatif d'avoir 4 ou plusieurs visites prénatales à réduire par un facteur de 0,7863 pour les femmes musulmanes ( p <0,05 ) , et une augmentation par un facteur de 5,3806 pour les femmes dans l'échelle sociale plus élevé ( p < 0,01 ) . La religion devrait être intégré dans les déterminants sociaux.

BackgroundFamily planning expansion has been identified as an impetus to harnessing Nigeria's demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria.DesignThe study utilised women's data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression.ResultsFindings showed that respondents in avoidable high-risk birth categories were less likely to use contraceptives compared to those at no risk [rate ratio 0.82, confidence interval: 0.76–0.89, p<0.001]. Education and wealth index consistently predicted significant differences in contraceptive use across the models.ConclusionsThe results of this study suggest that women in the high-risk birth categories were significantly less likely to use a modern method of contraception relative to those categorised as having no risk. However, there are huge sub-national variations at regional and state levels in contraceptive prevalence and subsequent high-risk births. These results further strengthen evidence-based justification for increased investments in family planning programmes at the state and regional levels, particularly regions and states with high unmet needs for family planning.