Women autonomy and demand for maternal health services in Nigeria: Evidence from the Nigeria Demographic and Health Survey

Innocent A. Ifelunini, Adzugbele S. Agbutun, Samuel C. Ugwu, Michael O. Ugwu


Improving women autonomy can be vital in determining the uptake of healthcare services, especially in a patriarchal society with gender rights concerns. Using the 2013 Nigeria Demographic and Health Survey and employing Zero Inflated Negative Binomial regression, the effect of household decision-making power with considerations to women autonomy on the demand for maternal health services in Nigeria was examined. The result of the analysis suggests that women autonomy in deciding expenditures on household healthcare services, and autonomy in deciding their income expenditures significantly increases the likelihood of demand for maternal healthcare services. On the other hand, when the husband/partner makes sole decision, as well as joint decision making concerning expenditure on household healthcare services and expenditure of woman’s income reduces the likelihood of demand for maternal healthcare services in the country. This reduction was however much more when husband alone takes the decision than when decisions were taken jointly. Other socioeconomic variables like higher maternal education, and household wealth, also increased the demand for maternal healthcare services. We recommend that government should put in place policies that will help increase women’s participation in household decision-making through the sensitization and capacity building initiatives such as improved educational quality for women. (Afr J Reprod Health 2022; 26[4]: 65-74).

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World Bank. United Nations Population Division's World Population Prospects 2017. 2017. Retrieved from http://datacatalog.worldbank.org/public-licenses#cc-by.

Solomon G and Memar A. The millennium development goals and the status of gender disparity in Ethiopia: achievements and challenges. Am. Sci. Res. J. Eng. Technol. Sci. (ASRJETS) 2014; 8 (1): 56-78.

Adepoju AA, Ogunniyi L and Agbedeyi D. The role of women in household food security in Osun State, Nigeria. International Journal of Agricultural Policy and Research 2015; 3(3):


Harriet T, Opoku-Asare NA and Anin EK. The Role of Women in Reducing Household Poverty in the Bongo District of the Upper East Region, Ghana. Journal of Arts and Humanities (JAH) 2014; 3(4).

Bradshaw S, Castellino J and Diop B. Women’s role in economic development: Overcoming the constraints. Sustainable Development Solutions Network Background paper for the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda 2013.

Grossman M. On the Concept of Health and the Demand for Health. Journal of Political Economy 1972; 80(2): 223-255.

Atsiya P, Atsiya G and Agbutun S. Land Ownership, Household Bargaining Power and Child Health Outcomes: Evidence from the NDHS. Journal of Economics and Allied Studies 2019; 3(1): 1-17.

Beegle K, Frankenberg E and Thomas D. Bargaining Power Within Couples and Use of Prenatal and Delivery Care in Indonesia. Studies in Family Planning 2001; 32(2): 130-146

Izugbara C, Wekesah FM and Adedini SA. Maternal Health in Nigeria: A Situation Update. African Population and Health Research Center (APHRC) 2016.

Acharya D, Bell J, Simkhada P, Teijlingen E and Regmi, P. Research Women's autonomy in household decision-making: a demographic study in Nepal. Reproductive Health 2010.

Melak A. Determinants of Women’s Participation in Decision Making on Household Income. Asia Pacific Journal of Research 2019.

Roy P, Haque S, Jannat A, Ali M and Khan M. Contribution of women to household income and decision making in some selected areas of Mymensingh in Bangladesh. Progressive Agriculture 2017; 28(2): 120-129.

Sultana A. Factors Effect on Women Autonomy and Decision-Making Power within the Household in Rural Communities. Journal of Applied Sciences Research 2011; 7(1): 18-22.

Osamor P and Grad C. Factors Associated with Women Health Care Decision-Making Autonomy: Evidence from Nigeria. Journal of Biosoc 2017; 1-16

Bloom SS, Wypij D and das Gupta M. Dimensions of Women's Autonomy and the Influence on Maternal Health Care Utilization in a North Indian City. Demography 2001; 38(1): 67-78.

Smith ME, Tawiah EO and Badasu DM. Why some women deliver in health institutions and others do not: A cross sectional study of married women in Ghana, 2008. African Journal of Reproductive Health 2012; 16(3): 36-47.

Singh K, Bloom S, Haney E, Olorunsaiye C and Brodish, P. Gender Equality and Childbirth in a Health Facility: Nigeria and MDG5. African Journal of Reproductive Health 2012; 16(3): 123-129.

Guyer J. “Endowments and assets: The anthropology of wealth and the economics of intrahousehold allocation.” In: L. Haddad, H. J., & A. H., Intrahousehold resource allocation in developing countries: models, methods and policy. Baltimore: Johns Hopkins Press 1997

Wooldridge J. Econometric Analysis of Cross Section and Panel Data. Massachusetts London, England: The MIT Press Cambridge. 2010.

Wang W and Famoye F. Modeling Household Fertility Decisions with Generalized Poisson Regression. Journal of Population Economics 1997; 10(3): 273-283.

Miles-Doan R and Brewster KL. The Impact of Type of Employment on Women's Use of Prenatal-Care Services and Family Planning in Urban Cebu, the Philippines. Studies in Family Planning 1998; 29(1): 69-78.

Schultz T. Studying the impact of household economic and economic variables on child mortality. Population and Development Review 1984; 10: 215-235.

Wang G. The Impact of Social and Economic Indicators on Maternal and Child Health. Social Indicators Research 2014; 116(3): 935-957.

Ugbor KI, Agbutun AS and Ugbor-Kalu UJ. Investigating the influence of community health insurance on health seeking behaviors and demand for maternal healthcare services in Nigeria. Journal of Public Affairs 2021): e2708. https://doi.org/10.1002/pa.270


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