Peer-reviewed article
Insight into Nigeria’s progress towards the universal coverage of reproductive, maternal, newborn and child health services: a secondary data analysis
Joy James Mafiana, Xiping Shen, Wenping Hu, Xiaohui Wang ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined Nigeria's progress in providing reproductive, maternal, newborn and child health services after adopting universal health coverage. The researchers analysed publicly available health data to measure how many women and children were receiving these services and whether coverage was equitable across different population groups. While overall coverage improved by 6.4 percentage points, it still fell 33.7 percentage points short of the 80% target. Large gaps persist, particularly between rich and poor populations, with the poorest groups having far lower access to services like immunisation.
Key points
- RMNCH service coverage index increased by 6.4 percentage points but remains 33.7 percentage points below the 80% universal coverage target
- The widest inequality in coverage is by economic status, with gaps ranging from 21.9 to 56.3 percentage points between rich and poor
- Three doses of diphtheria-tetanus-toxoid-pertussis immunisation showed the widest absolute inequality across population subgroups
- Coverage gaps persist among marginalised groups despite universal health coverage adoption
- The study calls for policies targeting disadvantaged populations and improved resource allocation to achieve equitable service coverage
Limitations
This is a secondary data analysis using aggregated data, so it cannot explain the reasons why coverage gaps exist or evaluate specific interventions to improve access. The study describes inequalities but does not assess the effectiveness of any particular policy or programme.
Abstract
Objective This study investigated the progress towards the universal coverage of reproductive, maternal, newborn and child health (RMNCH) services in Nigeria after universal health coverage (UHC) adoption. Design A descriptive observational approach was used based on secondary data analysis. Representative data generated from publicly accessible databases and reports were used to describe the coverage trend and estimate the absolute inequality. Analysis was conducted using Excel and the WHO’s Health Equity Assessment Toolkit software. Setting The study setting is Nigeria. Participants Aggregated health service coverage data of women aged 15–49 years and children under 5 years of age. Outcome measures The outcome of interest is the level of coverage of RMNCH services in Nigeria and the difference in equity gaps among subgroups before and after UHC adoption. Results The RMNCH index increased by 6.4% points with a difference of 33.7% points to attain the minimum 80.0% target. The widest inequality was by economic status with the difference ranging from 21.9% points (95% CI 10.1% to 33.8%) to 56.3% points (95% CI 51.5% to 61.2%), Absolute Concentration Index from 3.5% points (95% CI 1.6% to 5.5%) to 11.3% points (95% CI 10.4% to 12.2%), Slope Index of Inequality from 23.1% points (95% CI 11.9% to 34.2%) to 65.5% points (95% CI 62.6% to 68.5%) and population attributable risk from 9.3% points (95% CI 7.3% to 11.4%) to 31.2% points (95% CI 29.0% to 33.3%). Among the indicators, three doses of diphtheria–tetanus–toxoid–pertussis immunisation had the widest absolute inequality across the subgroups. Conclusion The poor coverage of RMNCH services in Nigeria and persistent inequalities pinpoint the need to investigate further the country-level determinant of RMNCH service coverage. In addition, it emphasises the need to formulate effective policies focusing on marginalised groups and improving resource allocation to ensure sustainable service coverage.