Demand for Women’s Health Services in Northern Nigeria: A Review of the Literature

Irit Sinai, Jennifer Anyanti, , Mohsin Khan, Ramatu Daroda, Olugbenga Oguntunde


Demand for and utilization of women‘s health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women‘s health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region‘s population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women‘s health-seeking behaviors for themselves and for their children. Programs seeking to improve women‘s health outcomes in northern Nigeria should involve women‘s influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services. (Afr J Reprod Health 2017; 21[2]: 96-108).

Full Text:



Goldberg A. Norms within Networks: Opinion Leader and

Peer Network Influences on Mothers/Caregivers' Childhood Immunization Decisions in Rural Northern Nigeria [dissertation], New York (NY): Columbia University; 2014.

Valente TW. Social network and health: models, methods,

and applications. New York: Oxford University Press. 2010

National Population Commission [Nigeria]. Priority table

Vol. III: Population distribution by sex, state, LGA, and senatorial district. Abuja, Nigeria: National Population Commission. 2010.

National Population Commission (NPC) [Nigeria] and ICF

International. Nigeria Demographic and Health Survey 2013. Abuga, Nigeria and Rockville, Maryland, USA: NPC and ICF International. 2014.

Abdul, MM, Onose M, Ibrahim MT, Voke‐Ighorodje M,

Adeyeye MO, Adeleke O, Adeleke O, and Babalola A. An analysis of the socio‐economic, socio‐cultural, religious, environmental, technological, language and educational factors on women‘s right in Nigeria: the case of Northern Nigeria, Fundación Mujeres; 2012.

Yusuf B. Sexuality and the Marriage Institution In Islam:

An Appraisal, Lagos, Nigeria: Africa Regional Sexuality Resource Centre. 2005.

Mercy Corps. Adolescent Girls in Northern Nigeria:

Financial Inclusion and Entrepreneurship Opportunities. [Cited 2016 June 30]. Available from northern-nigeria-financial-inclusion-and-entrepreneurship. 2013.

Wolf M, Abubakar A, Tsui S and Williamson NE. Child

Spacing Attitudes in Northern Nigeria. Washington (DC): FHI. 2008

Csapo M. Religious, Social and Economic Factors

Hindering the Education of Girls in Northern Nigeria. Comp Educ. 1981;17(3): 311-319.

Khalid, S. Socio-Economic and Cultural Roots of

Reproductive Health Care Problems in North-Western Nigeria, Sokoto, Nigeria: Usmanu Danfodiyo University. 2004. [cited 2016 June 30]. Available from

Public Opinion Polls. MotherCare Project. Arlington

(VA): John Snow [JSI]. 1993.

Aradeon SB, Onyekwere E, Iwere EN, Etta FE, Abdullahi

R, Oloko S and Tanko N. Sociocultural analysis of the USAID interventions in Nigeria : FHSII - family health services, CCCDII - maternal/child health, AIDSCAP - HIV /AIDS prevention and control, SBA Consultants; 1992.

Ibisomi, LDG. Fertility Transition in Nigeria: Exploring

the Role of Desired Number of Children. Nairobi, Kenya: African Population and Health Research Center. 2007.

Ankomah, A., Anyanti J, Adebayo S and Giwa A. Barriers

to contraceptive use among married young adults in Nigeria: A qualitative study. Int J Trop Disease & Health 2013;3 (3):267-282.

Idris SH, Sambo MN and Ibrahim MS. Barriers to

utilization of maternal health services in a semi-urban community in northern Nigeria: The client perspective. Nigeria Med J. 2013; 54 (1):27-32.

Izugbara CO and Ezeh AC. Women and High Fertility in

Islamic Northern Nigeria. Stud Family Plann. 2010; 1(3):193-204.

Aransiola, JO, Akinyemi AI, and Fatusi AO. Women's

perceptions and reflections of male partners and ouple dynamics in family planning adoption in selected urban slums in Nigeria: A qualitative exploration. BMC Public Health. 2014;14 (1): 1-14.

Austin A, Fapohunda B, Langer A and Orobaton N.

Trends in delivery with no one present in Nigeria between 2003 and 2013. Int J Women‘s Health. 2015;7:345-356.

Segun T, Ishola G, Sule S, Isiugo-Abanihe, U, Rawlins B

and Otolorin E (2007). Factors enabling and constraining the use of maternal and newborn health services in northern Nigeria: Formative research findings and implications. A poster presented at the 135st annual meeting of the American Public Health Association, Washington, (DC). 2007.

Solanke BL, Oladosu OA, Akinlo A and Olanisebe SO.

Religion as a social determinant of maternal health care service utilization in Nigeria. Afr Population Studies. 2015;29 (2):1868-1872.

Adamu YM and Salihu HM. Barriers to the use of

antenatal and obstetric care services in rural Kano, Nigeria. J Obst Gyn 2002;22(6):600-603.

Doctor HV, Findley SE, Ager A, Cometto G, Afenyadu

GY, Adamu F and Green C. Using community-based research to shape the design and delivery of maternal health services in Northern Nigeria. Reprod Health matter. 2012;20(39):104–112.

Kisekka MN. A brief on population and socio-cultural life

in Nigeria. Presented at the Training Course for Master Trainers' Workshop, University of Ilorin, October 19-20, 1988. [Cited 2016 June 30]. Available from

Wall, LL. Dead mothers and injured wives: the social

context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Family Plann. 1998;29(4):341-59.

Okeshola FB and Sadiq IT. Determinants of Home

Delivery among Hausa in Kaduna South Local Government Area of Kaduna State, Nigeria. American Int J Cont Research. 2013;3 (5):78-85.

Tukur, BM, Bawa U, Odogwu K, Adaji S, Suleiman I and

Passano P. Praying for Divine Intervention : The Reality of ―The Three Delays‖ in Northern Nigeria. Afr J Reprod health. 2010;14 (3): 113–120.

Ankomah A, Anyanti J and Oladosu M. Myths,

misinformation, and communication about family planning and contraceptive use in Nigeria. Open Access J Contraception 2011;2:95-105.

Ojanuga D and Johnson M. Hausa families and health care

choices: birth injuries in African communities. Family Systems Medicine. 1992;1 (4):413-421.

Schwandt, H. Perspectives on Family Planning in Ibadan

and Kaduna, Nigeria: A Qualitative Analysis, Nigerian Urban Reproductive Health Initiative. 2011.

Nigerian Urban Reproductive Health Initiative (NURHI),

A. Perspectives on Family Planning in Ibadan and Kaduna, Nigeria: A Qualitative Analysis, Nigerian Urban Reproductive Health Initiative. 2011. [cited 2016 June 30]. Available from %20-%20Focus%20Group%20Discussions%20Report.pdf.

Krenn, S, Cobb L, Babalola S, Odeku M and Kusemiju B.

Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative. Global Health: Science and Practice. 2014;2 (4): 427-443.

Izugbara CO, Ibisomi AC, Ezeh and M. Mandara.

Gendered interests and poor spousal contraceptive communication in Islamic northern Nigeria. J Fam Plan Reprod H. 2010; 36(4):219-224.

Abdulkareem S. Socio-Cultural and Economic Factors

Affecting Women's Access to Reproductive Health Services in Northern Nigeria. Academia; 2011. [cited 2016 June 30]. Available from

Shamaki MA and Buang A. Sociocultural practices in

maternal health among women in a less developed economy: An overview of Sokoto State, Nigeria. GEOGRAFIA. 2014;10 (6): 1-14.

Shamaki MA and Buang A. The Socio-cultural Behaviors

of Women‘s Health Facilities Utilisaiton in Northern Nigeria. Mediterr J Social Sciences. 2015;6(4): 517-534.

Iliyasu, Z, Aliyu MH, Abubakar IS and Galadanci HS.

Sexual and reproductive health communication between mothers and their adolescent daughters in northern Nigeria. Health Care women In. 2012;33 (2):138-52.

Nigerian Urban Reproductive Health Initiative (NURHI).

A Family Planning Social Mapping in Ibadan and Kaduna, Nigeria. 2011. [cited 2016 June 30]. Available from

UNFPA (2008). Conference on the role of

traditional/religious leaders on reduction of maternal mortalityand survival of women: Held at the Sokoto State College of Education Conference hall. [cited 2016 June 30]. Available from

Mairiga AG, Kyari O, Kulima A and Abdullahi H.

Knowledge, perceptions and attitudes of Islamic scholars towards reproductive health programs in Borno State, Nigeria. Afr J Reprod Health. 2007; 11(1):98-106.

Abdulkarim G, Mairiga AG, Kawuwa MB and Kullima

A.Community Perception of Maternal Mortality in Northeastern Nigeria. Afr J Reprod Health. 2008;12(3):27-34.

Gummi, FB, Hassan M, Shehu D and Audu L.

Community education to encourage use of emergency obstetric services, Kebbi State, Nigeria.The Sokoto PMM Team. Int J Gynecol Obstet. 1997;59 Suppl 2:S191- 200.

CEDPA. Engaging Social Networks in Family Planning

Programming: Lessons from Research and Interventions. A Report for: Terikunda Jekulu: Using Network Analysis to Address Unmet Need in Mali. 2012.

The Mitchel Group. The leadership development for

family planning / reproductive health for political office holders, traditional and religious leaders project: end-of-project performance evaluation final report. Washington (DC). 2014. [cited 2016 June 30]. Available from

[DHS, 2009] National Population Commission (NPC)

[Nigeria] and ICF International. Nigeria Demographic and Health Survey 2008. Abuga, Nigeria and Rockville, Maryland, USA: NPC and ICF International. 2009.

Nyako, Z, Yusuf S, Segun T, Airede L, Ishola G and

Otolorin EO. Use of Male Birth Spacing Motivators to Mobilize Communities for Family Planning Acceptance in Northern Nigeria. 2011 International Conference on Family Planning, Dakar Senegal. 2011. [cited 2016 June 30]. Available from

Arévalo M, Jennings V and Sinai I. ―Efficacy of a new

method of family planning: The standard Days Method‖. Contraception. 2001; 65(5):333-338.

Ujuju C, Anyanti J, Adebayo SB, Muhammad F, Oluigbo

O and Gofwan A. Religion, culture and male involvement in the use of the Standard Days Method: evidence from Enugu and Katsina states of Nigeria." Int Nurs Rev. 2011;58(4): 484-490.

Mangvwat, J, Ifenne E, Guthrie V and Masterson J.

Giving Women A Voice: The 100 Women Groups. Washington (DC): Centre for Development and Population Activities [CEDPA]. 2003.


  • There are currently no refbacks.