The Maternal, Newborn, and Child Health (MNCH) team and the Nigeria Country Office (NCO) at the Bill and Melinda Gates Foundation (BMGF) is focused on reducing maternal and child morbidity and mortality in Nigeria. To effectively achieve these goals, it is important to understand what drives demand and utilization of MNCH services. The BMGF approached the START Center to create health profiles for ten selected Nigerian states, collating data on ten selected MNCH health indicators from national surveys. In addition, the START team was asked to explore published literature that might help explain differences in health indicators between states, as well as what drives demand and utilization of MNCH services. Specifically, the team was asked to look at how vulnerabilities such as gender roles, religious affiliations, cultural norms, other social constraints such as abuse and disrespect or quality of care in health care settings, and variation between private and public health care systems impacted demand and utilization.
Through the collation of health indicator data, the START team ascertained that utilization of MNCH services tended to increase with increasing wealth or education. While most profiled states showed improvement in health indicators over the past 12 years, most were still below the national average. Details of each state were presented in one-page briefs. The literature review revealed that gender roles – particularly related to men’s power in health and financial decisions – and cultural norms that do not value antenatal care are two of the primary reasons for low demand and utilization of MNCH services; however, conclusions varied widely by region, making generalizing difficult. More details on each of the three topic areas were presented in the final report and presentation.