Academic journal article Gender & Behaviour

Women's Empowerment Status and Exposure to Maternal Mortality Risks in Nigeria

Academic journal article Gender & Behaviour

Women's Empowerment Status and Exposure to Maternal Mortality Risks in Nigeria

Article excerpt

Introduction

One of the Millennium Development Goals (MDGs) is the improvement of maternal health (MDG-5), the target of which is to reduce maternal mortality ratio by 75% between 1990 and 2015. However, the statistics on maternal mortality clearly show that Nigeria is lagging in the struggle to significantly improve maternal health. Annually, an estimated 50,000 to 59,000 Nigeria women of reproductive age die because of pregnancy and childbirth, a figure that is second only to India's (W. H. O. WHO, 2007, 2010). More worrisome is the fact that the country is currently not making adequate progress towards reduction of maternal deaths. According to figures published by the WHO, a country like India, with a population size of more than a billion, has reduced its maternal mortality figures from 136,000 in 2000 first to 117,000 in 2005 and further declined to 63,000 in 2008. Nigeria, with a population size of less than 150 million, first recorded an increase in number of maternal deaths from an estimated 37,000 in 2000 to 59,000 in 2005, though a later WHO report shows there is a reduction in the estimated number of maternal deaths in the country to 50,000 in 2008 (WHO, 2007, 2010).

Studies have shown that the low level of involvement of women in decision making process regarding maternal mortality related issues is a reason why there is still a high rate of maternal mortality in Nigeria. Generally, in matters relating to reproductive issues, women in several less developed societies hardly have a say, in many cultures, men make decisions that affect women's reproductive health as well as their own (Riley, 1997). Traditional societies often invest power and authority in males to make decisions and to control valued resources, especially in the case of patriarchal societies (Caldwell & Caldwell, 1983). For instance, in some parts of Nigeria, a woman with obstetric complications cannot receive medical attention without the permission of her husband (Adewuyi, 1999). A personal opinion of males within their familial context therefore often becomes the overriding factor in decisions pertaining to women's reproductive health.

This paper's objective is to examine how women's lack of control over their own reproductive health in particular, and lack of empowerment in household decision-making generally, impacts on their risk of exposure to maternal deaths in a high maternal mortality context like Nigeria.

Methods

The study utilised the individual women's data from the 2008 Nigeria Demographic and Health Survey (2008 NDHS) to examine the relationship between women's decisionmaking autonomy and exposure to mortality risks. Given that the study was interested in the risks of maternal mortality in the country, the analysis was restricted to only the women who had at least a birth in the last five years (preceding the survey). A total of 17635 women, out of the 33385 women interviewed nationwide in the 2008 NDHS, met the inclusion criteria. The analysis was done at univariate and bivariate levels. Also, using logistic regression models, multivariate analyses of the relationships between exposure to risks of maternal mortality and selected socio-economic and demographic variables were performed to estimate the odds associated with mortality risks for each of the predictor variables in the models.

Description and measurement of variables

The outcome variable was maternal mortality risk (measured as risks associated with nonuse of maternity care) while the main predictor variable was women empowerment (measured by generating an empowerment index from a set of questions in the NDHS).

Maternal mortality risks are the likelihood of dying or experiencing serious injury because of pregnancy or childbirth. While recognising the complex and diverse nature of the risks resulting in maternal mortality, for the scope of this study, we defined this as risks that are attributable to non-use of essential maternity care services during pregnancy and childbirth. …

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