ABSTRACT
The study provided an empirical evidence on effect of access and utilization of maternal health care services on arable crop production of rural women in south-east Nigeria. A multi-stage sampling procedure and purposive sampling technique were employed to select 360 rural farmers. Primary data were collected using structured questionnaire. Data collected were analyzed using descriptive statistics such as frequency, percentage, mean count, and standard deviation while inferential statistics such as OLS regression, simple linear regression, and ANOVA models was employed in testing the hypotheses for the study. The major result showed pooled grand mean of 3.04 affirmed that the respondent had high access to maternal health care services. A pooled grand mean of 3.13 indicating that rural women highly utilized maternal health care services. The results also showed a pooled grand mean of 3.53 indicating that the rural women affirmed that access to maternal health care services had positive effect. The result showed that the pooled grand mean of 3.03 indicating that the rural women affirmed that use of maternal health care services had effect. Furthermore, result showed that the key constraints of the respondents in accessing and utilizing maternal health care services in Southeast were inadequate human resources/health personnel (86.7%), poor information on Primary Health Care Services (86.4%), poor road infrastructure to facilitate access (83.9%), level of education of the women (80.3%), affordability of Healthcare Services (76.1%), the attitude of health care personnel (74.2%), inaccessibility and unavailability of health- care facilities (64.4%),location of the primary health care is far (56.4%), and cultural background of the woman (50.6%). Multiple regression estimates of relationship between selected socio-economic factors of the rural women and their access to maternal health care services revealed that age, marital status, level of education at, and monthly income were statistically significant. Multiple regression estimates of relationship between selected Socio-economic factors of the rural women and their use of maternal health care services revealed that marital status, household size , level of education , monthly income and distance to health centre. Simple linear regression on influence of access to MHCS on agricultural production among rural women was statistically significant and null hypothesis rejected. Duncan’s New Multiple Range Test (DNMRT) analysis revealed no significant difference in the access to maternal health care services across the states in South-East. Simple linear regression estimate of the effect of extent of utilization of maternal health care services on agricultural production of rural women was statistically significant. The study concluded that the rural women had high access and utilization of maternal health care services in southeast, Nigeria which led to increase in arable crop production and income of rural women. The study, therefore, recommends reduction in the cost of services and improving on the quality of maternal health care services especially for the poor and rural dwellers and also the empowerment of women are pre-requisites for any tangible improvement in the access and utilization of maternal healthcare in Nigeria.
TABLE OF CONTENTS
Title
page i
Declaration
ii
Certification iii
Dedication
iv
Acknowledgements
v
Table
of Contents
vi
List
of Tables x
List
of Figures
xii
Abstract xiii
CHAPTER 1: INTRODUCTION 1
1.1 Background
of the Study 1
1.2 Statement
of the Problem 8
1.3 Research
Question 12
1.4 Objectives
of the Study 12
1.5 Hypothesis 13
1.6 Significance
of the Study 14
1.7 Scope
of the Study 15
1.8 Definition
of Terms 16
CHAPTER 2: REVIEW OF RELATED LITERATURE 18
2.1 Conceptual Review
2.1.1 Millennium
development goals and rural women 20
2.1.2 Sustainable development goals and concept of
maternal
morbidity and mortality
26
2.1.3 Maternal
health services in Nigeria 30
2.1.4 Components
of maternal healthcare services 34
2.1.4.1 Antenatal care 34
2.1.4.2 Skilled birth attendants and maternal care 36
2.1.4.3 Post-natal-care
38
2.1.4.4 Child immunization 39
2.1.4.5 Breast feeding 40
2.1.4.6 Family planning 41
2.1.5 Access
of maternal health- care services 42
2.1.6 Utilization
of maternal health- care services 47
2.1.7 Factors
influencing utilization of maternal health-care services 49
2.1.7.1 Child bearing age 50
2.1.7.2 Birth order 52
2.1.7.3 Education 52
2.1.7.4 Employment quality and affordability of health-care services 53
2.1.7.5 Place of residence/availability 55
2.1.7.6 Religion and culture 55
2.1.8 Concept
of agricultural production 56
2.1.9 Concept
of arable crop production 57
2.1.10 Food security in Nigeria 58
2.1.11 Rural women and rural development in Nigeria 61
2.1.12 Agriculture and rural women development 64
2.1.13 Women in agriculture 66
2.1.14 Rural women 70
2.2 Review of Empirical Studies 72
2.3. Theoretical
Framework 78
2.3.1 Andersen
health-seeking behavioral model (AHBM) 78
2.3.1.1 Health policy 82
2.3.1.2 Characteristics of the healthcare delivery system 83
2.3.1.3 Characteristics of the
population at risk 84
2.3.1.4 Utilization of healthcare
services 87
2 3.1.5 Consumer satisfaction 88
2.3.2 Functionalism-the sick role 89
2.3.3 Feminist
theory 91
2.4 Conceptual Framework 92
CHAPTER
3: METHODOLOGY 96
3.1 Study
Area 96
3.2 Population
of Study 98
3.3. Sample
and Sampling Procedure 99
3.4 Data
Collection 101
3.5 Data
Analysis 102
3.6 Validation
of Instrument 104
3.7 Reliability
of Instrument 104
3.8 Measurement
of Variables 105
3.9 Model
Specification 108
CHAPTER 4: RESULTS AND DISCUSSION
4.1 Results 116
4.2 Socio-economic Profile of the Respondents 116
4.3 Maternal Health Care Services Available for Rural Women 121
4.4 Level of Access of Maternal Health Care
Services 122
4.5 Extent of Utilization of Maternal Health Care Services by
Rural Women 123
4.6 Estimates
of Farmers Output 125
4.7 Access to Maternal Health Care Services on
Rural Women 126
4.8 Perceived Effect of Using Maternal Health
Care Services on Output
of Arable Crop Production 129
4. 9 Constraints to Access of Maternal Health
Care Services 130
4.10 Constraints to Use of Maternal Health
Care Services by Rural Women
in the Study Area. 132
CHAPTER 5: SUMMARY, CONCLUSION AND RECOMMENDATION 145
5.1
Summary 145
5.2
Conclusion 150
5.3
Recommendations 151
References Appendix
LIST
OF TABLES
2.1: The 2021 macro trends historical life expectancy in Nigeria
was 54.81years. 30
2.2: Nigerian
women receiving prenatal care by zones for 2011 44
2.3: Maternal care indicators 2008 44
3.1: States
in South- East Nigeria, number of local government area and their
population 99
3.2: Selection of sample size according to local
government and state 101
4.1: Distribution
of respondents according to their socio-economic
characteristics 117
4.2: Distribution
of respondents based on maternal health-care services available
to
rural women. 121
4.3: Distribution of respondents based on
level of access maternal health-care services
available by rural women. 122
4.4: Distribution
of respondents based on extent of use of maternal health-care services available by rural women. 124
4.5: Performance
of the respondents using average seasonal yield as indicators 125
4.6: Mean
rating of perceived effect of access to maternal health-care
services available on rural women. 127
4.7 Mean rating of perceived effect of use
to maternal health-care services
available on rural women in the study area 129
4.8: Distribution
of respondents based on constraints to access of
maternal health-care services available on
rural women in the study area 131
4.9:
constraints to use of maternal health care services by rural women
in the study area. 132
4.10: Multiple regression estimates of relationship
between selected socio-
economic factors of the rural women
and their access to maternal health
care services. 134
4. 11
Multiple regression estimates of relationship
between selected socio-
economic factors of the rural women
and their use of maternal health
care services 137
4.12 Simple
linear regression influence of access to MHCS on agricultural
production among rural women in the
study area. 140
4.13 Duncan’s
new multiple range test (DNMRT) analysis of the mean
difference in the access to maternal health care services across
the
states in South-East 141
4.14
Simple linear regression estimate of the effect of extent of utilization of
maternal health care services on agricultural production of rural women
in
the study area. 142
4.15 ANOVA
(DNMRT) analysis of the mean difference
in the extent of
utilization
of maternal health care services across the states in
South-East 143
LIST
OF FIGURES
2.1
Maternal mortality rate (Nigeria) 33
2.2 Anderson
behavioral model, 1997 82
2.3 Conceptual framework on effect and
utilization of maternal Health-care services on
arable crop production and income of rural women 95
3.1 Multi-stage
sample technique 98
3.2 Map of
South East Nigeria 100
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Nigeria is a country blessed with a vast array of
arable land, from all regions of the country. All these regions of the country
are gifted with soils that are fertile for agricultural production. Food
Agricultural Organization (FAO, 2018) posits that even though oil accounts for
95 percent of Nigeria’s export revenue, and 76 percent of government revenue,
agriculture still remains the largest sector of the economy in Nigeria
employing over 67 % of the labour force in Nigeria, and serving as a potential
vehicle for diversifying the economy in Nigerian for economic development.
Aikhionbare (2016) argues that agriculture is the most viable route through
which Nigeria can successfully meander from her current economic downturn. FAO
(2018) further submitted that agriculture could promote economic development
through massive labour employment, foreign exchange earnings, food security,
and make available raw materials for industrialization.
Agriculture contributes to economic improvement in the
following ways: making available raw
material and food to non-agricultural areas of the economy; to create demand
for goods manufactured in non-agricultural areas; to enhance the strong point
of the acquiring power of rural people, through increased earnings on sale of
marketable surplus; to provide investable excess in the form of taxes and
savings to be put in non-agricultural area, making valued foreign exchange via
the exportation of agricultural products; and making available employment to a
huge crowd of backward, uneducated and unskillful labour (Macatta ,2016).
According to Oxford English Dictionary, Arable farming
( from Latin arabilis) meaning “able to
be plowed” is, land with the capability of being ploughed and employed to
cultivate crops. Arable farming is a branch of agriculture that provides staple
foods, medicine and aromatic plants for the world population (Krishnaswamy Aravid, Purushothaman Raja, and Manuel Perez-
Ruiz, 2017). Arable farming involves the production of wide-ranging annual
crops or food crops. This involves crops wherein the life cycle is within a
year; from the time of germination to food production and maturity. Arable
crops comprised; yam, cassava, cocoyam, maize, among others(Ibidapo , Ogunsipe
, Oso and Akinatade, 2018).In line with the Nigeria
Cassava Growers Association, the rise in the population of Nigerian and
Africans over the years has caused a rise in the demand for cassava and its
product and this development has resulted to higher revenue for farmers
throughout the world. Food crop has been grown for centuries and processed
into numerous products for example flour, starch, chips, glucose syrup, ethanol
and bread, among others. These products are in high demand locally, and
globally.
According
to Babatude (2019) with the progressively different use of annual crop products
in Nigeria, annual farming of crops is getting more profitable with each
passing day. The farm products have continuously been a means of living and
food for lots of Nigerians. 90% percent of households in Nigeria eat these
products everyday. A number of the meals are: wheat flour, garri, animal feed,
commercial caramel, and many others.
Agriculture has
moved from the traditional means of planting and harvesting to sustainable
agricultural production through
efficient use of productive resources in order to ensure food security, and
eradicate poverty.
Challenges
facing agriculture which include declining soil fertility, declining yields,
and low farmer incomes are often associated with low agricultural input use
suggesting that agricultural input use must increase for
significant productivity growth Agriculture has moved from the traditional means
of planting and harvesting to sustainable agricultural production through efficient use of productive
resources in order to ensure food security, and eradicate poverty. Challenges
facing agriculture which include declining soil fertility, declining yields,
and low farmer incomes are often associated with low agricultural input use
suggesting that agricultural input use must increase for significant productivity growth.
Agriculture has
moved from the traditional means of planting and harvesting to sustainable
agricultural production through efficient use of productive resources in order
to ensure food security, and eradicate poverty.
Challenges
facing agriculture which include declining soil fertility, declining yields,
and low farmer incomes are
often
associated with low agricultural input use suggesting that agricultural input
use must increase for significant productivity
growth. In effect, there is need to foster private sector–led development of
agricultural
input markets
(Freeman and Kaguo Traditionally, women are regarded as
homemakers, who oversee and coordinate the affairs and activities at home
(Oladejo et al., 2011).In fact,
women produce up to 80 percent of
essential foodstuffs, bear more than 90 percent of domestic production tasks,
and perform social tasks of bearing, nurturing, providing initial education for
children and ensure the wellbeing of the family and the entire society (Odeh
and Adiza, 2014). However, as a result of socio-cultural drift, rural women now
manage agricultural production, while their husbands and sons seek out other
forms of employment. As a result of this change, rural women manage complex
households and multiple livelihood strategies.
The part of rural women in agronomic production
predominantly in the production of arable crop cannot be over stressed. Amparo, et al.
(2019) further highlighted that the impact of women to labour in agriculture in
Africa is frequently cited in the range of 60 to 80 percent. Women constitute
up to 50 % of the labour force in agriculture in sub-Saharan. The average in
African ranges from fair above 40 % in Southern Africa to fair above 50 % in
Eastern Africa. These sub area average have remained equally constant since
1980, with the exclusion of Northern Africa, wherein the female portion seems
to increase from 30 - 45 %. The sub-regional data for Africa cover
broad variances among countries both in the portion of female labour in
agriculture and the drift. (FAO, 2011)
A basic need of the rural areas which can affect
arable crop agricultural production is health status of the women. According to
Mozaffarian (2016), employees with better health- care services not only have
far lower health-care costs, but miss fewer days of work. After a research conducted to analyze the
effect of health improvement on agricultural productivity, McNamara, Ulimnwngu,
and Leonard (2010) stated that in agricultural communities, poor health
decreases productivity and income, further lessening the ability of people to
address health and constraining economic growth.
Access to health services has to be guaranteed for all
people throughout the world according to SDGs (Sustainable Development Goals)
which is an expansion of MDGs (Millennium Development Goals) approved by
governments in the year 2000. The countdown has begun in September 2015 summit
on the SDGs with the national goals now discussing 17 goals that could transformed the world by the year 2030. The
SDGs goals that deals directly with the productivity and health status are:
- Goals 1: No poverty;
- Goal 2: No hunger
and
- Goal 3; Good health
which are in line with this study.
According to Lama and Krishna (2014), every year more
than half million women die due to complications of pregnancy and childbirth.
World Health Organization (WHO, 2018) stipulates that every day, 830 women
approximately die from avoidable causes associated with pregnancy and
childbearing. Almost 99 % of all maternal losses take place in developing
countries and half of all maternal losses take place in Sub-Saharan Africa.
Furthermore, WHO (2018) also posits that 78% of all estimated live births
benefitted from skilled care during delivery in 2016.
According to WHO (2011), and Fadeyi (2007), maternal
health (which is the physical wellbeing of a woman during pregnancy, delivery,
and post-partum) has been a major concern of several international summit in
2000 (WHO, 2007). At the millennium summit, it was general agreed that maternal
health-care has a crucial role to play in the improvement of reproductive
health, and that every woman deserve to be well up-to-date and empowered to
have unimpeded access to effective, safe, affordable, acceptable and
appropriate health-care services.
Maternal and Health care amenities are aimed at giving
adequate services to reproductive health. Reproductive health care services, according
to WHO (2018), are needed to avert maternal deaths and morbidity includes:
maternal health care (including ante-natal, child delivery and post-natal
care), family planning (contraceptive services and supplies), breast feeding
practices, child immunization, personal hygiene and nutrition education,
malaria prophylactic treatment prevention and management of sexually-
transmitted infections, including HIV and AIDS, prevention and management of infertility, abortion and
treating post-abortion complications, voluntary sterilization services and
cancers of the reproductive system.
Motherhood is frequently a fulfilling experience. Each
pregnant woman expects a baby full of life and lack of complicated
pregnancy. In sub- Saharan Africa, most
often is related with ill-health, suffering and even death. Most pathetic is
the fact that, pregnancy – related complications are avoidable, if appropriate
measures are taken and adequate care provided (WHO, 2011). There are two major
factors to be evaluated when dealing with maternal health- care services for
rural women, the first is the accessibility of adequate maternal health- care
services and the other deals with the adequate utilization of maternal health-
care services by the rural dwellers. Access to health-care services has a
countless deal of impact on reducing mortality rate for mother and child.
Access is defined as the prompt utilization of personal health services to
attain the greatest likely health outcomes. Access to health
amenities touches the well-being and health of individuals. Reliable and
regular access to health services can: Stop disability and disease, treat
sicknesses or other health challenges, Increase in the value of life, Lessen
the possibility of untimely (early) death and Increase in life expectation.
According to Lama and Krishna (2014), the application
of maternal health-care services varies from country to country and within
the country itself in numerous unindustrialized countries such as Nigeria. According
to Statista Account (2021), infant mortality rate mounted at 74.2 in 2019, 75.7
in 2018, 77.3 in 2017, 78.5 in 2016. Studies have shown that majority of
maternal deaths can be prevented or reduced if; women are healthy and well
nurtured before becoming pregnant, and had access to, or visited maternal
health- care service centers during pregnancy, delivery and the first month
after delivery through the utilization of the facilities provided at the health
care centers.
A
major significant factor in the under exploitation of maternal health -care
services by rural women and adolescents despite the availability of maternal
health-care facilities provided in the communities include low income of the
women, lack of information, proximity and the cultural background of the woman,
among others. In most African rural communities, maternal health- care services
co-exist with indigenous health -care services; therefore, women must choose
between the options. Therefore, the utilization and access of maternal health-
care services by rural women comes from an awareness of the efficacy of modern
health -care services and the religious beliefs of the individual women (World
Bank, 2019). Arthur (2012) noted that in most isolated rural areas in Africa,
differences in health- care that still occur are because of the lack of
availability and accessibility of health- care amenities and human resources;
poor road infrastructure to aid accessibility; and utilization of prenatal care
(ANC) by pregnant women.
Improving
accessibility and utilization of maternal health- care amenities is a global
challenge with worsen situation present in the sub-Saharan Africa and the Far
East. A number of programs are being carried out by local, state and federal
Government Ministries of Health, and Non Governmental Organizations (NGOs)
which have risen from these new policies. According to Mojekwu and Ibekwe (2012),
these initiatives possess common features of introducing free maternal care
through user-free waivers, and each case is championed by state commissioner of
Health. This process transcribes that the battle to combat high maternal
mortality is not just a medical or technical matter but, rather requires high
political commitment. According to punch Newspaper (2019), Lagos state
Government has put in place by various measures to ensure an effective health
care to tackle the twine issues of maternal and child mortality by providing a
wide spectrum of care in family planning, antenatal (ANC) and postnatal ( PNC)
to facilitate safety of women during child birth. WHO (2017) launched a
programme on ethics for reproductive, sexual, maternal, child, newborn and
adolescent health programme.
Rural
women work as salary earners, farmers and entrepreneurs. As women are
concentrated in unpaid and house- hold work and their role in subsistence
farming is often unremunerated, their contribution to the rural economy is
widely under estimated (International Labour Organization, 2021). Modern data
from numerous countries from Asia, Africa and Latin America designate that
women are far-off less expected to partake in rural wage service (both
non-agricultural and agricultural) than men.
When it has to do with work for earnings, rural women are more probably
to be hired in seasonal, part-time and/ or low paying work (ILO, 2014)
Thus, this thesis seek to evaluate the effect of
utilization and access of maternal health-care services on the production of
arable crop and revenue of rural women in south-east Nigeria.
1.2 PROBLEM STATEMENT
The effect of accessibility and application of
maternal health-care services on the production of arable crop of rural women
in South-East Nigeria may be enormous. Illness
is a main difficulty that hampers productivity in arable crop production. In
the situation where health status is low, there will be loss of labour-hours
that eventually leads to reduced productivity level and income in arable crop
production. Improving rural women accessibility to reproductive health is
significant to address starvation (FAO, 2011).
In developing countries, a greater number of women are dying due to
preventable illnesses associated with pregnancy and child bearing which cause
reduction in the production of arable crop through loss of labour as a huge
number of the manpower comes from the women (Hawkers and Ruel, 2006). Onasoga et
al. (2013) reported that for every woman that dies from pregnancy related
causes, 20 to30 or more will develop short or long term damage to their
reproductive organ resulting in disabilities thereby reducing arable crop
production.
Maternal health-care services were
introduced in line with MDGs (Millennium Development Goals). Millennium
Development Goals goal 8-lmprove maternal health. The health care services
include: ante-natal, child delivery and post-natal care, family planning
(contraceptive services and supplies), breast feeding practices, child
immunization, personal hygiene and nutrition education, malaria prophylactic
treatment prevention and management of sexually transmitted infections,
including HIV and AIDS, prevention and
management of infertility, abortion and in treating of post-abortion
complications, voluntary sterilization services and cancers of the reproductive
system.
Rural women farmers are responsible for
over 60 percent of the agricultural production in Nigeria (Agbarevo, 2008).
Hence need access to maternal health- care services as well as utilize these
services in order to participate productively in agriculture. In Nigeria, women
are actively involved in farming activities ranging from crop production,
animal husbandry to processing, storage, and marketing and constitute 60-85% of
the labour used for farming activities. Women are the strength of the growth of
National and rural economies. They encompass 43 percent of the agricultural
labor force in the World, which increases to 70 percent in certain countries.
Rural women have to trek a lengthy distances to transport water and fetch fire
wood, that is detrimental to human health, bringing about increased rates of
newborn and maternal death, retrogressive development in education and
threatening food dominion, in addition to food security and diet. Agriculture
is the key substitute for rural women, and it ought to come with superior
access to resources and land for the adaptation, prevention and mitigation of
climatic change, joined with rural women learning exactly how to deal with
cultural resistance and getting used to numerous expressions of this phenomenon
(Mucavelle, 2013). However, there has been food shortage
resulting from a consistent decline in food production; this is mainly due to a
combination of low income and reduced participation of rural women in
agriculture thus inadequate accessibility and application of maternal health
–care services.
Notwithstanding the point that the Nigerian government
accepted a primary health- care approach to health- care service provision to
ensure reasonable access to and application of health- care services to every community,
the country continually face challenges concerning access and application of
health- care services particularly in the rural communities. Antenatal
care(ANC) that is typically provided at primary health- care level is look upon
as the foundation for the accomplishment of the maternal and child health- care
programme. So, the necessity to highpoint matters of access to and application
of maternal health-care services is important due to poor access to and
under-utilization of maternal health- care services might possibly influence
the accomplishment of the Primary Health- Care System, pregnancy outcomes,
reduction in the production of arable crop and income of rural women. A
qualitative, exploratory, descriptive and contextual study conducted by Sibiya,
Ngzongo, and Bhengu (2018), where the majority of the study participants were
pregnant women, listed access to health- care and under-utilization of
antenatal services as a major challenge of pregnant women. In the same study,
nurses were reported to have recognized the challenges facing pregnant women
regarding the access and application of antenatal health- care services.
Findings from two nationally representative
surveys: NDS (Nigeria Demographic and
Health Survey) (2013) and NARHS (National AIDS and Reproductive Household
Survey) (2012) displayed that the percentage of pregnant women who had attended
any Nigerian Maternal Health- Care Services was 33.9 percent and 34.9 percent
respectively. In line with the 2013 NDHS, only 60.9 percent of women of child
bearing age (15 to 49 years) had a live birth in the 5 years prior to the
survey acquired maternal health -care from a qualified experienced maternal
health care worker (i.e., a nurse, doctor or midwife, or auxiliary nurse or
midwife). Simply half (51.0 percent) stated making four or more antenatal care
visits throughout the pregnancy. Approximately one-third (36 percent) of child
births were put to birth in a health facility whereas 38percent of all child
birth within the 5 years were aided by a skilled birth assistant (SBA). The
turnout of maternal care and child birth in a health center by a qualified
birth attendant are extremely lower than many other Africa countries. There is
a worldwide sensitization that a better quality care is vital to keep mothers
and their infants alive and well. Today, each day there are about 303,000 death
of women during pregnancy and childbearing, 2.6 million deaths at infant, and
2.7 million mortality of children during the first 28 days of existence. Better
care can prevent many of these deaths.
Nigeria’s agriculture is labour intensive, implying
that labour is an irreplaceable factor of production in agriculture in Nigeria,
(Ralji, 2005). As a result, any factor (whether economic or cultural) which
affects labour, in the case rural women would definitely affect their
contribution in the agricultural activities and, in essence their production
efficiency and income. The United Nations for Food and Agriculture Organization
(FAO, 2011) estimates that at least 80% of the rural small holders farmers
worldwide are small holder women.
There is therefore need to fill this gap. The under-
application of maternal health care services by rural women resulting to
under-productivity in the production of arable crop and low profits of the
rural women is a motivation for this study.
1.3 RESEARCH QUESTIONS
The following research questions will guide the study:
i.
What are the socioeconomic features of the respondents ?
ii.
What are the maternal health- care services available for rural women ?;
iii.
What is the access level of maternal health-care services by rural
women?;
iv.
What is the extent of utilization of maternal health -care services by
rural women?;
v.
What is the estimates of farmers output from
arable crop production?;
vi.
What is the effect of access of maternal health- care services on
rural women?;
vii.
What is the effect of utilization of maternal health- care services
on arable crop production? ;
viii.
What are the constraints to access
of maternal health- care services?;
ix.
What are the constraints to
utilization of maternal health- care services?.
1.4 OBJECTIVE OF THE STUDY
The broad objective of this research was to assess the
effect of access and application of maternal health- care services on arable
crop production and income of rural women in South-Eastern Nigeria.
The specific
objectives of the research were to:
1.
define the socioeconomic
features of the respondents;
2.
examine the maternal
health -care services available for rural women;
3.
ascertain the access
level of maternal health -care services
by rural women;
4.
ascertain the extent of
utilization of maternal health -care services
by rural women;
5.
estimate the farmers
output from arable crop production;
6.
determine the perceived effect of access of maternal health -care
services on rural women;
7.
ascertain the effect of utilization of maternal health- care services
on arable crop production;
8.
examine the constraints to
access of maternal health -care services; and
9.
examine the constraints to
utilization of maternal health -care services.
1.5 HYPOTHESES OF THE STUDY
The following null hypotheses are designed to guide
this study:
H01: There is no significant association
between the socioeconomic features of the rural women and their access to
maternal health- care services;
H02: There is no significant association
between the socioeconomic features of the rural women and extent of utilization
of maternal health- care services;
H03: Level of access of maternal health- care
services has no significant effect on arable crop production of rural women.
H04: There is no significant difference in
access to maternal health- care services
across the states studied
H05: Extent of utilization of maternal health
-care services has no significant effect on arable crop production of rural
women.
H06: There is no significant difference in the
extent of utilization of maternal health- care services across the states
studied.
1.6 SIGNIFICANCE OF THE STUDY
Rural women play significant role in arable crop
production. Most of the women involved in productivity fall within the
reproductive age and needs maternal health- care services for the well being of
mother and child without hampering production and revenue of the rural women
farmer. To this affect, data are needed to better understand the roles of rural
woman in the production of arable crop and how access and application of
maternal health -care services can affect the wellbeing of the rural farmers by
embracing new opportunities to ensure increase in the production of arable crop
and adequate increase in revenue of the rural women.
The justification of this study lay in its impact to
the growth of the current literature in support of the linkages between health
status of rural women, and production of arable crop of rural farmers.
Available studies, both in Nigeria and Sub-Saharan Africa showed a worrisome
linkage, and requires urgent policy remedial measures, which if adequately
harmonized, and jointly pursued by both sectors in agriculture and health, and
other relevant sectors, the synergies of increased arable crop productivity
because of good access and utilization of maternal health care services, rapid
rural development, reduced maternal death and ill health and socio-economic
development could be achieved, leading to achievement of maintainable development
objectives 1, 2 and 3.
To rural women, the ultimate purpose of this study is
to improve the reproductive health of the woman which will lead to increase in
arable crop productivity of the rural women. The study will help them to know
the maternal health- care facilities or packages available and also the need to
access and utilize those maternal health -care services available in health
centers. It is understood also that if the fees are subsides and the services
packaged in the language that they can comprehend, it will help her know about
her health needs which will strengthen her ability to make health resolutions
in the family and increase arable crop production as a healthy person can put
more hours in work.
To extension
agent, inputs of this work will expose the need to understand the health status of
the rural women as it is paramount for
them to be effective in arable crop production.
To government, federal
and state ministers of agriculture, policy maker, NGO’s, research institutions
and international organizations by accepting the policies that will enhance management of health information
system where women can at all times turn to for clarification on health facts. Also it will provide a good
basis for extension agents to work in hands with health officers in educating
rural women on access and utilization maternal health care services in increase
in output in arable crop production. Thus accomplishing the SDGs come 2030
To the researchers, the discoveries of this study will
form good resource materials for individuals who wish to carry out further
researches in related areas, which means that the findings will expose them to
more uncovered areas.
1.7 SCOPE OF THE STUDY
The thrust of this study is centered on
the effect of access and application of maternal health – care services on the
production of arable crop and revenue of rural women in south-east Nigeria. it
was limited to access to maternal
health-care services, utilization of maternal health- care services , effects
of access and utilization of maternal health- care services on arable crop
production and income of rural women in South-East of Nigeria which comprise of
the following states : Abia, Enugu, Imo, Anambra, and Ebonyi.. The health care
services include: ante-natal, child delivery and post-natal care, family
planning (contraceptive services and supplies), breast feeding practices, child
immunization, personal hygiene and nutrition education, malaria prophylactic
treatment prevention and management of sexually transmitted infections,
including HIV and AIDS, prevention and
management of infertility, abortion and in treating post-abortion
complications, voluntary sterilization services and cancers of the reproductive
system.. Arable crop are those crops that provides staple foods, medicine and
aromatic plants for the world population. They are mostly annual crops such as
cassava, rice, wheat, maize which rural women are involved in all the
activities of its production.
1.8 DEFINITION OF TERMS
Health: As
formally defined by the WHO (World Health Organization) is a state of complete
mental, physical and social well-being, not simply the lack of infirmity or
disease.
Maternal Health:
According to WHO (2018), maternal health denotes women’s health during
pregnancy, child bearing and the post partum period.
Maternal health
care services: This is the health services
rendered by the communities, families and health specialists to the expectant
woman throughout the period of pregnancy, child birth and after birth. This incorporates
the health care aspects of family planning, before conception, antenatal and
post-delivery care so as to guarantee a positive and satisfying experience in
majority of the cases and decrease maternal ill health and death in other
cases. (maternal health-Wikipedia)
Maternal
Mortality: This is the loss of a woman during
pregnancy or within 42 days of abortion of a pregnancy, regardless of the
period or position of the pregnancy, from any reason connected to, or
aggravated by pregnancy or its management, but not from accidental reasons.
Maternal
Morbidity: This denotes
the harmful state of an individual, whereas mortality denotes the state of being dead. The two perceptions can
be useful at the level of an individual or across a populace. For instance, a morbidity rate focuses on the
occurrence of a disease across a populace and/or geographical location
throughout a particular year.
Access to Maternal
Health Care Services: This refers to the
ability of an individual to utilized services and economic resources, social
resources as well as physical and geographical location in other to accomplish
the best health outcome.
Antenatal/prenatal
care: This is defined as the care which mothers
receive from healthcare professionals during pregnancy to ensure the delivery
of a healthy child and mother. It is a preventive health -care. Its objective
is to make available a regular check-up that permit mid-wives or doctors and
avoid likely health complications during the period of the pregnancy and to
stimulate healthy way of life that profit both child and mother.
It is a care made available by trained health-care
teenage girls so as to guarantee the best health environments for both the baby
and the mother during pregnancy.
Child Birth: This
include both (the birth process) and delivery ( the birth itself) it denotes
the process a baby sorts his or her way from the womb down the birth canal to
the external world.
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