Abstract:
ABSTRACT
The dominance of socio- cultural factors reduces women involvement in family issues, with grave implications for maternal health. This is evident in Northern Nigeria, where pregnancy and childbirth are the leading causes of diseases, disabilities and deaths among teenagers and women of reproductive age (WRA). However, there is a dearth of empirical studies to actually determine the impacts of these factors on maternal morbidity and mortality. This study, therefore, investigated the influence of social (age at first pregnancy, occupation, educational qualification, ethnic group, religion, marital status and number of wives in matrimonial home) and cultural (female circumcision, male dominance, wife inheritance, traditional birth practices, superstition and early marriage) factors on Maternal Morbidity and Mortality (MMM) in Benue and Borno states, Nigeria.
The survey research design was adopted. The multi-stage sampling procedure was used in selecting 1,650 respondents from the two states, comprising 660 WRA, 165 health providers and 825 teenagers. Cultural Factors, Maternal Morbidity and Mortality Questionnaire (r = 0.89) Social Factors Maternal Morbidity and Mortality Questionnaire Scale (r = 0.75) and MMM Questionnaire were used. These were complemented with eight sessions of Focus Group Discussions (FGD) and 33 Key Informant Interviews (KII) with WRA, teenagers and Maternal and Child Health coordinators. Four research questions and three hypotheses were answered and tested at 0.05 level of significance. Data were analysed using chi-square, Pearson’s Product Moment correlation, t-test and multiple regression. Qualitative data were content analysed.
Socio-cultural factors had significant joint correlation (r = .72) with MMM (F (16,1550) =106.88; p< 0.05); accounting for 53% in the variance of the dependent measure. There is no difference in the influence of socio- cultural factors with MMM in both Benue and Borno. However, the impact of the factors were more pronounced in Borno (x = 8.74) than in Benue (x = 4.31). The relative predictions of the social factors were: occupation (β = .13, p< 0.05), age at first pregnancy (β=.-11; p<0.05), religion (β = .08, p< 0.05), marital status (β = .04, p< 0.05), educational level (β=.-04; p<0.05), number of wives in matrimonial homes (β=.01, p<0.05) and ethnicity (β=.03; p>0.05). Cultural factors predicted MMM as follows: early marriage (β=.79, p<0.05), superstition (β=.65, p<0.05), male dominance (β=.64, p<0.05), traditional birth practices (β=.-52, p<0.05), wife inheritance (β=.-29, p<0.05) and female circumcision (β=.-22, p<0.05). The FGD and KII revealed that insistence on early marriages, wife inheritance and male dominance are jointly responsible for women of reproductive age inability to improve their educational and economic status as well as the decision to seek health needs as required. This assertion was stronger in Benue than in Borno. Further, women of reproductive age with higher education were more assertive and autonomous in utilising maternal healthcare services than those without any form of education.
Socio-cultural factors influenced maternal morbidity and mortality. Hence, intervention programmes targeted at reducing maternal morbidity and mortality should focus more on these socio- cultural factors, particularly early marriages, wife inheritance and male dominance.
Key Words: Socio-cultural factors, maternal morbidity and mortality, women of reproductive age, teenage mothers
Word Counts: 488
