Socio-Cultural Factors of Gender Roles in Women’s Healthcare Utilization in Southwest Nigeria
Affiliation(s)
1 Department of Economics and Development Studies, Covenant University, Ota, Nigeria. 2 Political Science and International Relations, Covenant University, Ota, Nigeria.
1 Department of Economics and Development Studies, Covenant University, Ota, Nigeria. 2 Political Science and International Relations, Covenant University, Ota, Nigeria.
ABSTRACT
Socio-cultural factors are threat to women’s health and well-being. A culture reinforces the gender role and life of husbands and wives. No matter how equipped a health facility is, it is the patronage that makes the difference to good health. People’s socio-cultural background plays vital role in seeking and acceptance of health care. The consequence of these factors on the use of health facility among pregnant women is a major cause of maternal morbidity and mortality and a powerful brake on the road to the achievement of MDGs as well as overall development. Maternal mortality in Nigeria is very high, with an estimated 52,900 Nigerian women dying from pregnancy-related complications out of a global total of 529,000 maternal deaths. It is not encouraging to note that 62 percent of births in Nigeria occur at home and 96 percent of women who received no ANC services delivered at home. Several factors lead to health care facility utilization and among these the less studied is the socio-cultural dimension and hence the focus of the paper. The study was carried out in Ado-Odo/Ota local government area with 260 eligible respondents, selected randomly from the eight wards in the local government. Interview approach was employed with the aid of structured questionnaire to elicit required information from the respondents and data analyzed using SPSS. The main objective of this study is to understand the influence of socio-cultural factors influencing health care utilization among women during pregnancy and child birth. The findings show that husband perception of pregnancy complications, age at marriage, who pays ante-natal bills, family type, treatment place decision are significant towards use of health care services by mothers. Paper provides recommendations for improving the use of maternal health delivery services in the study area and beyond.
Socio-cultural factors are threat to women’s health and well-being. A culture reinforces the gender role and life of husbands and wives. No matter how equipped a health facility is, it is the patronage that makes the difference to good health. People’s socio-cultural background plays vital role in seeking and acceptance of health care. The consequence of these factors on the use of health facility among pregnant women is a major cause of maternal morbidity and mortality and a powerful brake on the road to the achievement of MDGs as well as overall development. Maternal mortality in Nigeria is very high, with an estimated 52,900 Nigerian women dying from pregnancy-related complications out of a global total of 529,000 maternal deaths. It is not encouraging to note that 62 percent of births in Nigeria occur at home and 96 percent of women who received no ANC services delivered at home. Several factors lead to health care facility utilization and among these the less studied is the socio-cultural dimension and hence the focus of the paper. The study was carried out in Ado-Odo/Ota local government area with 260 eligible respondents, selected randomly from the eight wards in the local government. Interview approach was employed with the aid of structured questionnaire to elicit required information from the respondents and data analyzed using SPSS. The main objective of this study is to understand the influence of socio-cultural factors influencing health care utilization among women during pregnancy and child birth. The findings show that husband perception of pregnancy complications, age at marriage, who pays ante-natal bills, family type, treatment place decision are significant towards use of health care services by mothers. Paper provides recommendations for improving the use of maternal health delivery services in the study area and beyond.
Cite this paper
Azuh, D. , Fayomi, O. and Ajayi, L. (2015) Socio-Cultural Factors of Gender Roles in Women’s Healthcare Utilization in Southwest Nigeria. Open Journal of Social Sciences, 3, 105-117. doi: 10.4236/jss.2015.34013.
Azuh, D. , Fayomi, O. and Ajayi, L. (2015) Socio-Cultural Factors of Gender Roles in Women’s Healthcare Utilization in Southwest Nigeria. Open Journal of Social Sciences, 3, 105-117. doi: 10.4236/jss.2015.34013.
References
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http://dx.doi.org/10.1111/j.1728-4465.2002.00299.x [5] Jejeebhoy, S.J. (2001) Women’s Autonomy in India and Pakistan: The Influence of Religion and Region. Population and Development Review, 27, 687-712.
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http://dx.doi.org/10.2307/172248 [20] Soares, R.R. (2005) Mortality Reductions, Educational Attainment, and Fertility Choice. American Economic Review, 95, 580-601. http://dx.doi.org/10.1257/0002828054201486 [21] Mosley, W.H. and Lincoln, C.C. (1984) An Analytical Framework for the Study of Child Survival in Developing Countries. Population and Development Review, 10, 25-45.
http://dx.doi.org/10.2307/2807954 [22] Mosley, W.H. (1984) Child Survival: Research and Policy. Population and Development Review, 10, 3-23. http://dx.doi.org/10.2307/2807953 [23] Preston, S.H. and Haines, M.R. (1991) Fatal Years: Child Mortality in Late Nineteenth Century America. Princeton University Press, Princeton. http://dx.doi.org/10.1515/9781400861897 [24] Subramanian, S.V., Belli, P. and Kawachi, I. (2002) The Macroeconomic Determinants of Health. Annual Review of Public Health, 23, 287-302. http://dx.doi.org/10.1146/annurev.publhealth.23.100901.140540 [25] Marmot, M. (2005) Social Determinants of Health Inequalities. The Lancet, 365, 1099-1104.
http://dx.doi.org/10.1016/S0140-6736(05)74234-3 [26] Lieberman, E.S. (2007) Ethnic Politics, Risk, and Policy-Making: A Cross-National Statistical Analysis of Government Responses to HIV/AIDS. Comparative Political Studies, 40, 1407-1432.
http://dx.doi.org/10.1177/0010414007306862 [27] Bloom, S.S., Wypij, D. and Das Gupta, M. (2001) Dimensions of Women’s Autonomy and the Influence on Maternal Health Care Utilization in a North Indian City. Demography, 38, 67-78.
http://dx.doi.org/10.1353/dem.2001.0001 [28] Addai, I. (2000) Determinants of Use of Maternal Child Health Services in Rural Ghana. Journal of Biosocial Science, 32, 1-15. [29] Adetunji, J.A. (1991) Response of Parents to Five Killer Diseases among Children in a Yoruba Community, Nigeria. Social Science and Medicine, 32, 1379-1387. http://dx.doi.org/10.1016/0277-9536(91)90198-L [30] World Health Organization (1998) Improved Access to Maternal Health Service. World Health Organization, Geneva. [31] Biratu, B.T. and Lindstrom, D.P. (2006) The Influence of Husbands’ Approval on Women’s Use of Prenatal Care: Results from Yirgalem and Jimma Towns, South West Ethiopia. Ethiopian Journal of Health Development, 20, 84-92. [32] Addai, I. (1998) Demographic and Socio-Cultural Factors Influencing Use of Maternal Health Services in Ghana. African Journal of Reproductive Health, 2, 73-80. [33] Leslie, J. and Gupta, G.R. (1989) Utilization of Formal Services for Maternal Nutrition and Health Care. International Center for Research on Women, Washington DC. [34] Kistiana, S. (2009) Socio-Economic and Demographic Determinants of Maternal Health Care Utilization in Indonesia. Unpublished Master’s Theses, The Flinders University of South Australia, Adelaide. [35] Okeshola, F.B. and Ismail, T.S. (2013) Determinants of Home Delivery among Hausa in Kaduna South Local Government Area of Kaduna State, Nigeria. American International Journal of Contemporary Research, 3, 78. [36] Elo, I.T. (1992) Utilization of Maternal Health Care Services in Peru: The Role of Women’s Education. Health Transition Review, 2, 49-69. [37] Gabrysch, S. and Campbell, O.M.R. (2009) Still Too Far to Walk: Literature Review of the Determinants of Delivery Service Use. BMC Pregnancy and Childbirth, 9, 34. http://dx.doi.org/10.1186/1471-2393-9-34 [38] Omoruyi, G. (2008) Causes of Maternal Mortality in Nigeria. Sunday Observer. [39] Lawoyin, T.O., Lawoyin, O.O.C. and Adewole, D.A. (2007) Men’s Perception of Maternal Mortality in Nigeria. Journal of Public Health Policy, 28, 299-318. http://dx.doi.org/10.1057/palgrave.jphp.3200143 [40] Ajiboye, O.E. and Adebayo, K.A. (2012) Socio-Cultural Factors Affecting Pregnancy Outcome among the Ogu Speaking People of Badagry Area of Lagos State, Nigeria. International Journal of Humanities & Social Science, 2, 133. [41] Ewa, E.E., Lasisi, C.J., Maduka, S.O., Ita, A.E., Ibor, U.W. and Anjorin, O.A. (2012) Perceived Factors Influencing the Choice of Antenatal Care and Delivery Centres among Childbearing Women in Ibadan North South-Western, Nigeria. Ethiopian Journal of Environmental Studies and Management, 5, 373-383. http://dx.doi.org/10.4314/ejesm.v5i4.6 [42] Onasoga, O.A., Afolayan, J.A. and Oladimeij, B.D. (2012) Factors Influencing Utilization of Antenatal Care Services among Pregnant Women in Ife Central Lga, Osun State, Nigeria. Advances in Applied Science Research, 3, 1309-1315. [43] Owumi, B. and Raji, S.O. (2013) Socio-Cultural Determinants of Maternal Health Care Seeking Behavior in Seme Side of Benin Republic. African Journal of Social Sciences, 3, 145-158. [44] Muchabaiwa, L., Mazambani, D., Chigusiwa, L., Bindu, S. and Mudavanhu, V. (2012) Determinants of Maternal Healthcare Utilization in Zimbabwe. International Journal of Economic Sciences and Applied Research, 5, 145-162. [45] Stephenson, R., Baschieri, A., Clements, S., Hennink, M. and Madise, N. (2006) Contextual Influences on the Use of Health Facilities for Childbirth in Africa. American Journal of Public Health, 96, 84-93. http://dx.doi.org/10.2105/AJPH.2004.057422 [46] World Health Organization (2005) The World Health Report 2005. World Health Organization, Geneva. [47] Mekonnen, Y. and Mekonnen, A. (2002) Utilization of Maternal Health Care Services in Ethiopia. ORC Marco, Maryland. [48] Navaneetham, K. and Dharmalingam, A. (2000) Utilization of Maternal Healthcare Services in South India. Faculty Seminar at the Centre for Development Studies, Thiruvananthapuram, 31 March 2000, 1-40. [49] Boyle, M.H., Racine, Y., Georgiades, K., Snelling, D., Hong, S., Omariba, W., Hurley, P. and Rao-Melacini, P. (2006) The Influence of Economic Development Level, Household Wealth and Maternal Education on Child Health in the Developing World. Social Science and Medicine, 63, 2242-2254. http://dx.doi.org/10.1016/j.socscimed.2006.04.034 [50] McCarthy, J. and Maine, D. (1992) A Framework for Analyzing the Determinants of Maternal Mortality. Studies in Family Planning, 23, 23-33. http://dx.doi.org/10.2307/1966825 [51] Dairo, M.D. and Owoyokun, K.E. (2010) Factors Affecting the Utilization of Antenatal Care Services in Ibadan, Nigeria. Benin Journal of Postgraduate Medicine, 12, 3-13. [52] Kabir, M., Iluyasu, Z., Abubakar, I.S. and Sani, A.A. (2005) Determinants of Utilization of Antenatal Care Services in Kumbotso Village, Northern Nigeria. Tropical Doctor, 35, 110-111.
http://dx.doi.org/10.1258/0049475054036814 [53] Biratu, B.T. and Lindstrom, D.P. (2000) The Influence of Husbands’ Approval on Women’s Use of Prenatal Care: Results from Yirgalem and Jimma Towns, South West Ethiopia. Ethiopian Journal of Health Development, 20, 84-92. [54] White, D., Dynes, M., Rubardt, M., Sissoko, K. and Stephenson, R. (2013) The Influence of Intra-Familial Power on Maternal Health Care in Mali: Perspectives of Women, Men and Mothers-in-Law. International Perspectives on Sexual and Reproductive Health, 39, 58-68. [55] Fayomi, O.O. and Igbokwe, N. (2009) Women’s Reproductive Health—A Question of Human Rights in the context of HIV/AIDS in Nigeria. MP: A Feminist Journal (Gender and Race), 2, 30. [56] Azuh, D. (n.d.) Socio-Demographic Factors Influencing Health Programme Usage by Pregnant Mothers in Nigeria: Implications for Policy Action. Unpublished Work, Covenant University, Ota.
[1] Federal Ministry of Health (2007) Nature, Strategic Framework on the Health and Development of Adolescents and Young people in Nigeria. Federal Ministry of Health, Abuja. [2] Nigeria Demographic and Health Survey (NDHS) (2000) Nigeria: DHS, 1999—Final Report. Measure DHS, Calverton. [3] Jenna, K, Muller, B. and Quiros, A. (2009) Women, Men, and the Changing Role of Gender in Immigration. Student Research Series, 3, 1-14. [4] Jejeebhoy, S.J. (2002) Convergence and Divergence in Spouses’ Perspectives on Women’s Autonomy in Rural India. Studies in Family Planning, 33, 299-308.
http://dx.doi.org/10.1111/j.1728-4465.2002.00299.x [5] Jejeebhoy, S.J. (2001) Women’s Autonomy in India and Pakistan: The Influence of Religion and Region. Population and Development Review, 27, 687-712.
http://dx.doi.org/10.1111/j.1728-4457.2001.00687.x [6] Adewuyi, A. (1999) Understanding Male Involvement in Maternal Emergencies. Oke Gada, Ede. [7] Renne, E.P. (1993) Gender Ideology and Fertility Strategies in an Ekiti Yoruba Village. Studies in Family Planning, 24, 343-353. http://dx.doi.org/10.2307/2939244 [8] Omideyi, A. (1987) Status, Cultural Beliefs and Fertility Behavior among Yoruba Women. In: Ebigbola, J. and Van de Walle, E., Eds., The Cultural Roots of African Fertility Regimes: Proceedings of the Ife Conferences, Obafemi Awolowo University, Ile-Ife and University of Pennsylavania, Philadelphia, 151-165. [9] Mama, A. (1996) Women’s Studies and Studies of Women in Africa during the 1990s. Working Paper Series 5/96, CODESRIA, Daker. [10] Longwe, S.H. (2002) Assessment of the Gender Orientation of NEPAD. In: Nyong’o, P.A., Ed., New Partnership for Africa’s Development NEPAD: A New Path, Heinrich Boll Foundation, Nairobi, 252-274. [11] Shah, I.H. and Say, L. (2007) Maternal Mortality and Maternity Care from 1990-2005: Uneven but Important Gains. Reproductive Health Matters, 15, 17-27. http://dx.doi.org/10.1016/S0968-8080(07)30339-X [12] Ujah, I.A.O., Aisien, O.A., Mutihir, J.T., Vanderagt, D.J., Glew, R.H. and Uguru, V.E. (2005) Factors Contributing to Maternal Mortality in North-Central Nigeria: A Seventeen-Year Review. African Journal of Reproductive Health, 9, 27-40. http://dx.doi.org/10.2307/3583409 [13] Dyson, T. and Moore, M. (1993) On Kinship Structure, Female Autonomy and Demographic Behaviour in India. Population and Development Review, 9, 35-60. http://dx.doi.org/10.2307/1972894 [14] Parpart, J., Connelly, M. and Barriteu, V. (2000) Theoretical Perspectives on Gender and Development. International Development Research Centre, Ottawa. [15] Caldwell, J.C. (1986) Routes to Low Mortality in Poor Countries. Population and Development Review, 12, 171-220. http://dx.doi.org/10.2307/1973108 [16] Caldwell, J.C. (1977) Towards a Restatement of Demographic Transition Theory. In: John, C.C., Ed., The Persistence of High Fertility, Australian National University, Canberra, 25-119. [17] Afonja, S. (1986) Women Power and Authority in Traditional Yoruba Society. In: Dube, L., Leacock, E. and Ardener, S., Eds., Visibility and Power, Bergin and Garvey, South Hadley, 136-157. [18] Obermeyer, C.M. (1993) Culture, Maternal Health Care, and Women’s Status: A Comparison of Morocco and Tunisia. Studies in Family Planning, 24, 354-365. http://dx.doi.org/10.2307/2939245 [19] Wall, L.L. (1998) Dead Mothers and Injured Wives: The Social Context of Maternal Morbidity and Mortality among the Hausa of Northern Nigeria. Studies in Family Planning, 29, 341-359.
http://dx.doi.org/10.2307/172248 [20] Soares, R.R. (2005) Mortality Reductions, Educational Attainment, and Fertility Choice. American Economic Review, 95, 580-601. http://dx.doi.org/10.1257/0002828054201486 [21] Mosley, W.H. and Lincoln, C.C. (1984) An Analytical Framework for the Study of Child Survival in Developing Countries. Population and Development Review, 10, 25-45.
http://dx.doi.org/10.2307/2807954 [22] Mosley, W.H. (1984) Child Survival: Research and Policy. Population and Development Review, 10, 3-23. http://dx.doi.org/10.2307/2807953 [23] Preston, S.H. and Haines, M.R. (1991) Fatal Years: Child Mortality in Late Nineteenth Century America. Princeton University Press, Princeton. http://dx.doi.org/10.1515/9781400861897 [24] Subramanian, S.V., Belli, P. and Kawachi, I. (2002) The Macroeconomic Determinants of Health. Annual Review of Public Health, 23, 287-302. http://dx.doi.org/10.1146/annurev.publhealth.23.100901.140540 [25] Marmot, M. (2005) Social Determinants of Health Inequalities. The Lancet, 365, 1099-1104.
http://dx.doi.org/10.1016/S0140-6736(05)74234-3 [26] Lieberman, E.S. (2007) Ethnic Politics, Risk, and Policy-Making: A Cross-National Statistical Analysis of Government Responses to HIV/AIDS. Comparative Political Studies, 40, 1407-1432.
http://dx.doi.org/10.1177/0010414007306862 [27] Bloom, S.S., Wypij, D. and Das Gupta, M. (2001) Dimensions of Women’s Autonomy and the Influence on Maternal Health Care Utilization in a North Indian City. Demography, 38, 67-78.
http://dx.doi.org/10.1353/dem.2001.0001 [28] Addai, I. (2000) Determinants of Use of Maternal Child Health Services in Rural Ghana. Journal of Biosocial Science, 32, 1-15. [29] Adetunji, J.A. (1991) Response of Parents to Five Killer Diseases among Children in a Yoruba Community, Nigeria. Social Science and Medicine, 32, 1379-1387. http://dx.doi.org/10.1016/0277-9536(91)90198-L [30] World Health Organization (1998) Improved Access to Maternal Health Service. World Health Organization, Geneva. [31] Biratu, B.T. and Lindstrom, D.P. (2006) The Influence of Husbands’ Approval on Women’s Use of Prenatal Care: Results from Yirgalem and Jimma Towns, South West Ethiopia. Ethiopian Journal of Health Development, 20, 84-92. [32] Addai, I. (1998) Demographic and Socio-Cultural Factors Influencing Use of Maternal Health Services in Ghana. African Journal of Reproductive Health, 2, 73-80. [33] Leslie, J. and Gupta, G.R. (1989) Utilization of Formal Services for Maternal Nutrition and Health Care. International Center for Research on Women, Washington DC. [34] Kistiana, S. (2009) Socio-Economic and Demographic Determinants of Maternal Health Care Utilization in Indonesia. Unpublished Master’s Theses, The Flinders University of South Australia, Adelaide. [35] Okeshola, F.B. and Ismail, T.S. (2013) Determinants of Home Delivery among Hausa in Kaduna South Local Government Area of Kaduna State, Nigeria. American International Journal of Contemporary Research, 3, 78. [36] Elo, I.T. (1992) Utilization of Maternal Health Care Services in Peru: The Role of Women’s Education. Health Transition Review, 2, 49-69. [37] Gabrysch, S. and Campbell, O.M.R. (2009) Still Too Far to Walk: Literature Review of the Determinants of Delivery Service Use. BMC Pregnancy and Childbirth, 9, 34. http://dx.doi.org/10.1186/1471-2393-9-34 [38] Omoruyi, G. (2008) Causes of Maternal Mortality in Nigeria. Sunday Observer. [39] Lawoyin, T.O., Lawoyin, O.O.C. and Adewole, D.A. (2007) Men’s Perception of Maternal Mortality in Nigeria. Journal of Public Health Policy, 28, 299-318. http://dx.doi.org/10.1057/palgrave.jphp.3200143 [40] Ajiboye, O.E. and Adebayo, K.A. (2012) Socio-Cultural Factors Affecting Pregnancy Outcome among the Ogu Speaking People of Badagry Area of Lagos State, Nigeria. International Journal of Humanities & Social Science, 2, 133. [41] Ewa, E.E., Lasisi, C.J., Maduka, S.O., Ita, A.E., Ibor, U.W. and Anjorin, O.A. (2012) Perceived Factors Influencing the Choice of Antenatal Care and Delivery Centres among Childbearing Women in Ibadan North South-Western, Nigeria. Ethiopian Journal of Environmental Studies and Management, 5, 373-383. http://dx.doi.org/10.4314/ejesm.v5i4.6 [42] Onasoga, O.A., Afolayan, J.A. and Oladimeij, B.D. (2012) Factors Influencing Utilization of Antenatal Care Services among Pregnant Women in Ife Central Lga, Osun State, Nigeria. Advances in Applied Science Research, 3, 1309-1315. [43] Owumi, B. and Raji, S.O. (2013) Socio-Cultural Determinants of Maternal Health Care Seeking Behavior in Seme Side of Benin Republic. African Journal of Social Sciences, 3, 145-158. [44] Muchabaiwa, L., Mazambani, D., Chigusiwa, L., Bindu, S. and Mudavanhu, V. (2012) Determinants of Maternal Healthcare Utilization in Zimbabwe. International Journal of Economic Sciences and Applied Research, 5, 145-162. [45] Stephenson, R., Baschieri, A., Clements, S., Hennink, M. and Madise, N. (2006) Contextual Influences on the Use of Health Facilities for Childbirth in Africa. American Journal of Public Health, 96, 84-93. http://dx.doi.org/10.2105/AJPH.2004.057422 [46] World Health Organization (2005) The World Health Report 2005. World Health Organization, Geneva. [47] Mekonnen, Y. and Mekonnen, A. (2002) Utilization of Maternal Health Care Services in Ethiopia. ORC Marco, Maryland. [48] Navaneetham, K. and Dharmalingam, A. (2000) Utilization of Maternal Healthcare Services in South India. Faculty Seminar at the Centre for Development Studies, Thiruvananthapuram, 31 March 2000, 1-40. [49] Boyle, M.H., Racine, Y., Georgiades, K., Snelling, D., Hong, S., Omariba, W., Hurley, P. and Rao-Melacini, P. (2006) The Influence of Economic Development Level, Household Wealth and Maternal Education on Child Health in the Developing World. Social Science and Medicine, 63, 2242-2254. http://dx.doi.org/10.1016/j.socscimed.2006.04.034 [50] McCarthy, J. and Maine, D. (1992) A Framework for Analyzing the Determinants of Maternal Mortality. Studies in Family Planning, 23, 23-33. http://dx.doi.org/10.2307/1966825 [51] Dairo, M.D. and Owoyokun, K.E. (2010) Factors Affecting the Utilization of Antenatal Care Services in Ibadan, Nigeria. Benin Journal of Postgraduate Medicine, 12, 3-13. [52] Kabir, M., Iluyasu, Z., Abubakar, I.S. and Sani, A.A. (2005) Determinants of Utilization of Antenatal Care Services in Kumbotso Village, Northern Nigeria. Tropical Doctor, 35, 110-111.
http://dx.doi.org/10.1258/0049475054036814 [53] Biratu, B.T. and Lindstrom, D.P. (2000) The Influence of Husbands’ Approval on Women’s Use of Prenatal Care: Results from Yirgalem and Jimma Towns, South West Ethiopia. Ethiopian Journal of Health Development, 20, 84-92. [54] White, D., Dynes, M., Rubardt, M., Sissoko, K. and Stephenson, R. (2013) The Influence of Intra-Familial Power on Maternal Health Care in Mali: Perspectives of Women, Men and Mothers-in-Law. International Perspectives on Sexual and Reproductive Health, 39, 58-68. [55] Fayomi, O.O. and Igbokwe, N. (2009) Women’s Reproductive Health—A Question of Human Rights in the context of HIV/AIDS in Nigeria. MP: A Feminist Journal (Gender and Race), 2, 30. [56] Azuh, D. (n.d.) Socio-Demographic Factors Influencing Health Programme Usage by Pregnant Mothers in Nigeria: Implications for Policy Action. Unpublished Work, Covenant University, Ota.