Social Behavioural Strategies for Addressing Rural-Urban Disparities in Maternal Health Care and Women's Health-Seeking Behaviour in Asaba, Nigeria

Rural–urban disparities in maternal health care utilisation remain a significant public health challenge in Nige-ria, contributing to preventable maternal morbidity and mortality. In Asaba, Delta State, these disparities areinfluenced by complex interactions among structural barriers, sociocultural beliefs, and gender dynamics thatshape women’s health-seeking behaviour. This study aimed to: assess differences in maternal health care utili-sation between rural and urban women in Asaba; examine the sociocultural and behavioural factors influencingwomen’s health-seeking behaviour; explore the role of community norms, beliefs, and gender dynamics inshaping maternal health decisions; and identify challenges limiting the implementation of equitable maternalhealth interventions. A descriptive cross-sectional survey was conducted among 400 women aged 18–49 yearsin rural and urban communities of Asaba, using structured questionnaires. Data were analysed using descrip-tive statistics (frequencies and percentages) to compare patterns and disparities between rural and urbanrespondents. Results revealed significant disparities, with urban women reporting higher rates of antenatalcare attendance (85% vs. 55%), skilled birth attendance (82.5% vs. 47.5%), and postnatal care use (77.5%vs. 42.5%). Sociocultural beliefs, including reliance on supernatural causes and preference for traditionalbirth attendants, were more prevalent among rural respondents. Gender dynamics significantly influencedcare-seeking, with 75% of rural women reporting husbands as primary decision-makers for delivery location.Key challenges to equitable interventions included distance to facilities, high costs, negative health workerattitudes, and insufficient community engagement. Addressing these disparities requires integrated, gender-responsive, and culturally sensitive strategies, such as expanding rural health infrastructure, reducing financialbarriers, improving quality of care, engaging communities, and promoting social and behaviour change com-munication tailored to local contexts. Strengthening women’s autonomy and transforming restrictive gendernorms are critical for achieving equitable access to skilled maternal health services.