Influence of the Socioeconomic Position and Health Literacy of Men on the Maternal and Child Health Outcomes of Households in Nigeria

Abstract

The advancement of the highest possible wellbeing for women and children remains a foremost global health goal. Nigeria accounts for a significant proportion of the persisting burden of preventable maternal and child morbidity and mortality. Hitherto, the role of healthcare services and women-factors have been extensively studied worldwide and within the Nigerian context. However, there is little published understanding of how men-specific factors affect Maternal and Child Health (MCH). Given that men are statutorily positioned, culturally and socioeconomically, to exert influence on health-related decision-making and actions in households, this study conjectured that the stagnated improvement in the MCH indices of Nigeria could be partially attributed to unexplored factors of men.

Specifically, the study assessed, quantified and determined the effects of the Socio-Economic Position (SEP) and Health Literacy (HL) of men on Maternal and Child Wellbeing (MCW) in Nigerian households.

Using a nationally representative, cross-sectional sample of Nigerian households obtained in 2018 by the Demographic and Health Survey (DHS) Program, SEP, HL and MCW were systematically defined, operationalized and assessed based on literature evidence and novel approaches. Robust descriptive, bivariate, and multiple linear regression techniques were applied to ascertain relationships and effects.

Independently, the MCW index of Nigerian households was significantly predicted by the SEP and HL of men, with no interaction/joint effects. Higher SEP and HL among men were consistently associated with a higher MCW. Notably, the main effects of SEP and HL on MCW remained statistically significant following adjustment for household, women and other men factors, at the 95% confidence level.

These findings provide valuable new insights into the overall understanding of the influence of men on their families' health. It suggests that targeted reproductive, maternal and child health education of men can help improve MCH outcomes in Nigeria and similar contexts. Multi-sectoral policy changes to enhance the SEP of men and incorporate essential MCH knowledge into mandatory pre-nuptial counselling and school curricula at all levels are indicated in the medium and long-term. This study mainstreams the importance of scaling up research to routinely measure how male factors influence the health of women and children in all settings.