Socio-Cultural Determinants of Maternal Healthcare Utilization in Maradun Local Government Area, Zamfara State

Maternal healthcare utilization (MHC) remains a major concern in northern Nigeria, where social, cultural, economic and household factors influence women’s use of ANC, delivery and postnatal care. This study examined socio-cultural factors influencing MHC utilization in Maradun LGA, Zamfara State, focusing on ANC, place of delivery and PNC, using a cross-sectional mixed-methods design. Quantitative data were collected using a structured questionnaire, while qualitative data were obtained through key informant interviews with healthcare workers, TBAs and community leaders. Of 360 questionnaires distributed, 342 were retrieved and analyzed. Quantitative data were analyzed using descriptive statistics, while qualitative data were subjected to thematic analysis. The findings showed low utilization of MHC services. About 45.6% of respondents reported no ANC attendance during their last pregnancy, while 47.3% reported delivering their last child at home and 73.4% reported no postnatal care attendance. The findings also revealed a strong cultural orientation toward managing pregnancy and childbirth within the household. Overall, 57.9% agreed or strongly agreed that pregnancy should be managed mainly at home, while 61.2% agreed or strongly agreed that cultural traditions encourage home delivery. Household decision-making was predominantly male-centred, with 54.1% identifying husbands as the main decision-makers for MHC. Qualitative findings showed that cultural beliefs, trust in TBAs, postpartum seclusion, family influence and husbands’ control of resources shaped women’s healthcare experiences. These findings demonstrate that MHC utilization in Maradun is socially embedded, requiring culturally responsive education, male engagement, strengthened women’s decision-making and collaboration with traditional and community structures.