Women’s empowerment and live birth registration coverage in Nigeria: a geostatistical assessment

Progress towards universal birth registration coverage has continued to lag in many developing countries despite continued interests and investments by governments and international agencies. As the primary caregiver, women are often saddled with the responsibility of getting their children’s birth registered and may be motivated to do so. However, this may not come to reality in situations where they are not empowered to participate in household decision-making that allows them to mobilize resources for this purpose. This study set out to investigate the spatially varying relationship between women’s empowerment and birth registration coverage at disaggregated level of States in Nigeria. Using data from the 2018 Nigeria Demographic and Health Survey, we constructed indices for women’s empowerment regarding household decision-making and healthcare utilization through factor scores generated from factor analysis that pooled several related questions on each of the empowerment indicators. Each woman was then classified into one of highly empowered, moderately empowered or less empowered category, and a geostatistical model that considers the neighbourhood structure of the spatial units was used to quantify the spatially-varying relationship with birth registration while accounting for other possible determinants. The results show huge variation in the likelihood of registering births among the highly empowered women. Though coverage appears to be generally lower in most northern States, there are a few States where the highly empowered women have high chances of registering their births. Birth registration coverage could benefit from interventions that seek to enhance women’s participation in household decision-making everywhere in the country.