Multilevel Modelling of Determinants of Maternal Health Care Utilization in Nigeria

Dorothy Ononokpono, University of Uyo

Despite the high maternal mortality ratio in Nigeria, utilization of maternal health care services is still poor. Attempts to explain this situation have focused on individual and household-level factors. We examined community-level determinants of the use of maternal health care in Nigeria. Our sample consists of women aged 15-49 years drawn from 2008 Nigeria Demographic and Health Survey. We employed multilevel analysis to identify community factors associated with the use of antenatal and delivery care. The two maternal health indicators showed that women who lived in Northern Nigeria were disadvantaged than those who resided in the South. Women who lived in communities with high proportion of educated women were 1.3 times more likely to have institutional delivery. Community poverty and ethnic diversity were negatively associated with antenatal and delivery care respectively. Increasing education coupled with efforts to reduce poverty in disadvantaged communities is a gateway to alleviating maternal health problems.