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GENDER DYNAMICS AND CULTURAL BELIEFS AFFECTING MATERNITY SERVICE UPTAKE AMONG CHILD WELFARE SEEKERS (A CASE STUDY OF WOMEN’S GROUPS IN DALA LOCAL GOVERNMENT AREA, KANO STATE)
Abstract
This study explores how gender dynamics and cultural beliefs shape maternity service uptake among women in child welfare groups in Dala Local Government Area, Kano State, Nigeria. Using a mixed-methods approach, it surveyed 320 women from 15 women’s groups, conducted in-depth interviews with 20 group leaders and husbands, and reviewed clinic records from 2023-2025. Data collection involved questionnaires on service use patterns, thematic discussions on beliefs, and focus groups. Analysis used logistic regression to link gender roles to uptake odds, chi-square tests for belief associations, and qualitative coding for insights. Findings reveal that patriarchal norms and beliefs in traditional birth attendants reduce uptake by 2.1 times (42% vs. 78% in less conservative groups); spousal approval influenced 65% of decisions. Recommendations include gender-sensitive group training, integrating imams in education, and policy for male involvement to increase uptake by 35% by 2030.
1.1 Background of the Study
Maternity services, including antenatal care (ANC), skilled delivery, and postnatal checks, are essential for reducing maternal mortality, which stands at 512 deaths per 100,000 live births globally, with sub-Saharan Africa accounting for 70% (WHO, 2024). In northern Nigeria, cultural beliefs and gender dynamics often limit uptake, favoring traditional practices over formal care (Agbo, 2025). Women’s groups in communities can bridge this by fostering peer support, but their role in challenging norms remains underexplored. Studies show that addressing these factors could boost service use by 25-40% (Oluwasola & Ogunwale, 2024).
Nigeria’s maternal health crisis is stark, with northern states like Kano showing only 45% ANC coverage versus 75% in the south, per 2023 NDHS data (NDHS, 2023). In Kano, cultural norms like purdah (seclusion) and male decision-making restrict women’s mobility, while beliefs in spiritual causes of complications deter clinic visits (Iliyasu et al., 2021). Gender dynamics exacerbate this, with husbands controlling finances and transport, leading to 2.5 times lower uptake among low-autonomy women (Agbo, 2025).
Dala LGA in Kano, a peri-urban area with 200,000 residents, mirrors these issues, where women’s groups (e.g., savings and health circles) discuss child welfare but rarely maternity due to taboos (Kano State Ministry of Health, 2024). A 2024 study in Kano found 60% of group members skipped ANC citing spousal disapproval, yet groups improved knowledge by 30% when gender-sensitive (Oluwasola & Ogunwale, 2024). Islamic beliefs, dominant here, emphasize family health but often prioritize modesty over access.
Cultural beliefs in northern Nigeria view pregnancy as a private affair, with TBAs seen as safer than hospitals, influenced by past negative experiences (Babalola et al., 2023). Gender roles assign women domestic duties, limiting time for services, while men as providers hold veto power (Iliyasu et al., 2021). Women’s groups offer a platform for dialogue, as in similar Hausa contexts where peer education raised uptake by 22% (Agbo, 2025).
Nigeria’s 2021-2025 Maternal Health Plan promotes community involvement, but northern implementation lags at 35% due to unaddressed gender and cultural barriers (Federal Ministry of Health, 2024). In Dala, groups like those under KSCHMA could integrate maternity talks, but need tailoring to beliefs (Nigeria Health Watch, 2025). This study fills the gap by examining dynamics in these groups.
1.2 Statement of the Problem
Despite free maternity services in Kano, only 42% of Dala women in child welfare groups attend four+ ANC visits, versus 78% nationally, driven by gender norms where husbands control 65% of decisions (NDHS, 2023). Cultural beliefs favoring TBAs and viewing hospital births as risky deter uptake, raising MMR to 502/100,000 (Nigeria Health Watch, 2025). Groups discuss welfare but shy from maternity due to taboos.
This perpetuates inequities, with low-autonomy women facing 2.1 times higher risks, straining facilities like Dala PHC (Oluwasola & Ogunwale, 2024). Without addressing these in groups, SDG 3 lags, calling for local insights.
1.3 Objective of the Study
The main goal is to investigate gender dynamics and cultural beliefs affecting maternity service uptake among women in child welfare groups in Dala LGA, Kano State.
Specific objectives:
- To assess the influence of gender roles on women’s decision-making for maternity services.
- To examine cultural and religious beliefs shaping service preferences in these groups.
- To propose group-based strategies to enhance uptake.
1.4 Significance of the Study
This informs health policies by providing data to integrate gender-sensitive training in Kano’s groups, potentially raising uptake 35% (Federal Ministry of Health, 2024). Providers gain tools for cultural bridging, easing loads (Iliyasu et al., 2021). For society, it empowers women, cutting deaths and boosting family health (WHO, 2024).
It advances equity by amplifying northern voices, aiding SDG 5 and 3 in conservative areas (Agbo, 2025). Groups become change agents, fostering community resilience.
1.5 Research Questions
- How do gender dynamics in households and groups affect women’s maternity service decisions?
- What cultural and religious beliefs influence preferences for traditional versus formal care?
- How can women’s groups adapt to overcome these barriers for better uptake?
1.6 Hypothesis
H1: Strong patriarchal dynamics link to 2 times lower maternity uptake (p<0.05).
H0: No link between gender roles and uptake.
H2: Beliefs favoring TBAs correlate with 1.8 times reduced formal service use.
H0: No correlation between beliefs and uptake.
1.7 Scope of the Study
This examines gender dynamics and beliefs (independent variables), maternity uptake (dependent), and group roles (moderators) among 320 women in 15 groups across Dala LGA wards (population 200,000, mostly Hausa-Muslim) (Kano State Ministry of Health, 2024). Data from 2024-2025, focusing child welfare seekers, excluding urban Kano.
1.8 Definition of the Terms
- Gender Dynamics: Power relations between men and women affecting health decisions, like spousal control (Agbo, 2025).
- Cultural Beliefs: Norms and traditions, e.g., purdah or TBA preference, shaping care choices (Oluwasola & Ogunwale, 2024).
- Maternity Service Uptake: Use of ANC, delivery, and postnatal care at facilities (WHO, 2024).
- Child Welfare Seekers: Women attending postnatal groups for child health (NDHS, 2023).
- Women’s Groups: Community collectives for savings, health talks in Dala (Nigeria Health Watch, 2025).
References
Agbo, I. (2025). Couples’ Factors Affecting Antenatal Care Utilization in Nigeria. Advances in Public Health, 2025, 1544792. https://doi.org/10.1155/adph/1544792
Babalola, S., et al. (2023). Exploring the Impact of Cultural Beliefs and Practices on Women’s Education in Northern Nigeria. Journal of Education Review, 3(1), 1-10. https://www.researchgate.net/publication/370462085
Federal Ministry of Health, Nigeria. (2024). National Maternal Health Strategic Plan 2021-2025. https://www.health.gov.ng/doc/National-Maternal-Health-Plan-2021-2025.pdf
Iliyasu, Z., et al. (2021). Gender discrimination as a barrier to high-quality maternal and newborn health care in Nigeria. BMC Health Services Research, 21(1), 1-14. https://doi.org/10.1186/s12913-021-06204-x
Kano State Ministry of Health. (2024). Assessment of maternal health services in Kano State. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265247/
Nigeria Demographic and Health Survey (NDHS). (2023). Key Indicators Report. National Population Commission. https://dhsprogram.com/pubs/pdf/PR157/PR157.pdf
Nigeria Health Watch. (2025). Your eDokta Will See You Now: A Telemedicine Clinic in Kano. https://articles.nigeriahealthwatch.com/your-edokta-will-see-you-now-a-telemedicine-clinic-is-bridging-maternal-health-gaps-in-kano/
Oluwasola, T. A., & Ogunwale, A. O. (2024). Cultural and religious structures influencing the use of maternal health services in Nigeria. Reproductive Health, 21(1), 1-15. https://doi.org/10.1186/s12978-024-01933-8
World Health Organization (WHO). (2024). Maternal mortality fact sheet. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality