Closing the gap in maternal healthcare in Nigeria: Are women with low socioeconomic status still left behind?

Despite global and national efforts to improve maternal health, Nigeria continues to record high maternal mortality rates, primarily driven by the underutilization of essential maternal health services. This study examines the association between women’s socioeconomic status(SES) and the utilisation of antenatal care (ANC), skilled birth attendance (SBA), postnatal care (PNC), and contraceptive use (CPuse), while controlling for demographic and contextual factors. Using data from the 2017 Multiple Indicator Cluster Survey (MICS), a weighted sample of reproductive-age women (15–49 years) was analysed through both bivariate and multivariate logistic regression models. Results from the bivariate analysis revealed a strong, positive correlation between SES and utilisation of all four maternal health services. Women in the high SES group were significantly more likely to access ANC (β=1.218, p<0.001), SBA (β=2.644, p<0.001), PNC (β=1.342, p<0.001), and CPuse (β=1.189, p<0.001) compared to those in the low SES group. However, multivariate analysis revealed that the positive association between high SES and PNC diminished after controlling for education, parity, media exposure, and region. Education, urban residence, ethnicity, and media access remained significant predictors of service utilisation. Notably, parity was inversely associated with SBA and PNC, while regional disparities persisted across all outcomes. These findings underscore the need for targeted, equity-focused interventions that address structural and informational barriers among socioeconomically disadvantaged women. Strengthening maternal healthcare systems through culturally tailored programs, expanded media outreach, and enhanced financial protection mechanisms is essential to reducing inequalities and achieving maternal health targets under SDG 3 in Nigeria.