EFFECTS OF MATERNAL HEALTH CARE UTILISATION ON CHILD IMMUNISATION AND MOTHER’S WELLBEING AMONG AGRICULTURAL HOUSEHOLDS IN RURAL NIGERIA

Abstract

The health of a mother before, during and after pregnancy is essential for the wellbeing of the household, generally and that of the mother and child, specifically. Maternal Health Care Utilisation (MHCU) in rural Nigeria is low with high maternal mortality. It has also been established that MHCU is a veritable input that could improve child health outcomes through child immunisation. There is limited empirical evidence that link MHCU to child immunisation and mother’s wellbeing therefore, effect of MHCU on child immunisation and mother’s wellbeing among agricultural households investigated. Secondary data sourced from 2018 National Demographic Health Survey (for rural Nigeria) were utilised in this study. Information used included household characteristics (age, education of household heads, region and household size), child characteristics (age, birth order, sex and birth weight), mothers’ characteristics (occupation, age at first birth, education and media exposure). The level of MHCU was profiled across the six geopolitical zones of Nigeria and its variables were; delivery in health care facility, availability of skilled birth attendant and postnatal care. The MHCU was categorised into low (≤0.333), moderate (0.334-0.667) and high (0.668-1.00) levels among mothers while child immunisation status was categorised into unimmunised (not vaccinated), partially (uncompleted vaccination) and fully immunised. Wellbeing Index (WI) was categorised into low (≤0.333), moderate (0.334-0.667) and high (0.668-1.00) wellbeing levels. Data were analysed with descriptive statistics, multiple correspondence analysis, Fuzzy set analysis, Tobit regression model and extended ordered logit model at α0.05. The age of household heads, household size and age of mothers at first birth were 44.7±9.9 years, 8.3±3.6 persons and 18.5±3.8 years, respectively. Majority of mothers were uneducated (59.65%). Children were male (51.47%), with third or above birth order (90.66%) and not weighed at birth (84.05%). The mean MHCU was 0.54±0.23 among mothers. Mothers with moderate MHCU were (39.1%). More mothers in South West (24.16%) and North Central (17.1%) had low MHCU. Mother’s occupation (β = -0.0383), education (β = -0.0669), age at first birth (β = -0.0082), media exposure (β = -0.0347), sex of household head (β = -0.0394) and birth order (β = 0.0198) influenced MHCU. Children (55.85%) were unimmunised and were found in the North West and the North East zones. Mean WI of mothers was 0.424±0.167 and most mothers had moderate WI (74.77%). The MHCU (β=0.042) and husband’s education (β = 0.068) improved partially immunised status in children while husband’s education (β = 0.0247) and mothers fully employed into agriculture (β = 0.0107) improved child’s full immunisation status. Furthermore, MHCU (β = 0.0912), household size (β = 0.0105) and mothers fully employed in agriculture (β = 0.0060) improved moderate wellbeing status in mothers while household size ((β = 0.0003) and mothers fully employed in agriculture (β = 0.0016) improved mother’s high wellbeing status. Maternal health care utilisation improved child immunisation status and mother’s wellbeing among agricultural households in rural Nigeria.