Locus of control and utilization of skilled birth care in Nigeria: The mediating influence of neuroticism
(2022) European Health Economics Association PhD Student-Supervisor Conference — Location: Galway, Ireland (29.August.2022)
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- et. al.
- Abstract
- Objectives: Low utilization of maternal and child healthcare services remain a challenge in low and lower-middle-income countries. While several studies have documented that financial barrier disproportionately, discourage poor women from seeking needed maternal and child healthcare, empirical evidence reveal instances where even with provision of financial assistance and other initiatives to improve healthcare services utilization, women continued not utilizing skilled maternity care. In this study, we investigated the influence of locus of control and the Big-Five personality traits on utilization of skilled maternity care in Nigeria. Specifically, we explored the correlations between locus of control and personality traits to ascertain the relationship between non-cognitive traits and utilization of skilled maternity care. We further explored how the Big-Five personality traits mediated the relationship between locus of control and utilization of skilled maternity care. Methods: We used data from an intervention project to increase women’s access to skilled maternal and child healthcare services, conducted in two communities in southern Nigeria between August 2017 and June 2020. The intervention consisted in providing financial assistance to pregnant women in form of a community-based health insurance scheme that subsidized cost of delivery by 80%. Additionally, women in the programme were provided with mobile phones with dedicated SIM cards linked to health care providers and transporters to ease access to health care facilities. We utilized two data collection points. The baseline questionnaire carried out before the intervention in 2017 consisted of pre-validated questions adapted from the Nigeria Demographic and Health Survey. It included questions on women’s socio-demographic characteristics, partners’ and other family characteristics, reproductive history, and antenatal, intrapartum and postnatal care experience for current pregnancy and births in the preceding 5 years. In addition to the baseline survey questionnaire, we added to the follow-up survey conducted in July 2020 a set of standardized questions on locus of control and self-esteem to investigate whether and how women’s non-cognitive traits matter for the utilization of skilled maternity care. Results: Estimating logistic regression models, we found that women’s internal locus of control was a significant predictor of utilization of skilled maternity care. We found significant associations between the components of the Big-Five personality traits and the utilization of skilled maternity care. We also found some of the components of the Big-Five personality traits (Conscientiousness, Neuroticism and Openness to experience) as significant predictors of locus of control. Discussion: By improving our understanding of non-cognitive and psychological traits as possible barriers to utilization of skilled maternity care, our findings offer important insights for enhancing participants’ engagement in intervention programs that are initiated to improve maternal health outcomes in low and lower-middle-income countries.
- Affiliations
Centre of Excellence in Reproductive Health Innovation, Nigeria
Citations
Aikpitanyi, J., & et al. (2022). Locus of control and utilization of skilled birth care in Nigeria: The mediating influence of neuroticism. European Health Economics Association PhD Student-Supervisor Conference, Galway, Ireland. https://hdl.handle.net/2078.5/30394