Socio-economic inequalities in access to maternal and child healthcare in Nigeria: changes over time and decomposition

This paper examines socio-economic inequalities in maternal and child health care in Nigeria over an 18-year period. Studies demonstrate that maternal and child mortality is much higher amongst the poor in low-income countries, with access to health care concentrated among the wealthiest. Evidence suggests that in Nigeria inequalities in access to quality services continue to persist. We use data from two rounds of the Nigerian Demographic and Heath Survey (NDHS) conducted in 1990 and 2008 and measure inequalities in maternal and child health care variables across socio-economic status using concentration curves and indices. Factors contributing to the inequalities are investigated using decomposition analysis. The results show that in 1990, maternal access to skilled assistance during delivery had the highest levels of inequalities. It reveals that child and maternal health inequalities appear to be determined by different factors and while inequalities in child care have declined, inequalities in maternal care have increased. We discuss the findings in relation to the much greater attention paid to child health programmes. The findings of this study call for specific maternal programmes targeting the poor, less educated and rural areas in Nigeria.