Novel Approaches for Evidence-Based Health Policies for Women of Reproductive Age: Small Area Estimation of Population Data

With increasing demographic transition and change in population dynamics, there is a need to delineate population data to accommodate the heterogeneity of various socio-demographic groups. In Africa, women of reproductive age differ by risks process, urbanization, and geopolitical regions, which provides a challenge for policy implementation. In many instances, reproductive health policies are rather generic; they are extended to all women of reproductive ages and do not account for disparities among vulnerable rural women. Consequently, since challenges and choices differ for women in rural environments, pooling programs and intervention without adaptive solutions, This current study explores the use of existing population data to demonstrate the disparity in reproductive health experiences/outcomes of women in various residential settings in Nigeria. This provides a baseline for measuring the progress of reproductive health interventions. We included all 38,948 responses of women of reproductive ages into the weighted analysis of the 2013 Demographic and Health survey for Nigeria dataset. The explorative analysis was carried out to explore the experiences of these women, considering their places of residence. There were 480 maternal deaths reported by the respondents, among their siblings. There were 44,623 live births in the three years preceding the survey. Also, our findings show a higher percentage of births and maternal deaths happened in rural areas compared to the urban areas. About 71.0 % of the maternal deaths observed in the dataset, were reported by women who lived in rural places of residences. Additionally, 70.6 % of all the births reported in the survey were from women who resided in rural environments. This study has successfully provided a disaggregated approach which would serve as a baseline for formulating tailor-made reproductive health policies in Nigeria. It can be deduced that the experiences of women of reproductive years differ by several factors, one of which is the type of their places of residence. According to WHO, 515,000 women die globally due to pregnancy related causes. Nigeria contributes a burden of 14% and 71% of those deaths occur in rural Nigeria. This suggests a need for decentralization of health policies to focus on women in the rural environments. As the choice is the highest form of empowerment, decentralization of reproductive health policies, programs, and intervention should harness the option of an evidence-based empowerment approach. This would result in more effective interventions and programs for rural women. This inclusion, in turn, breeds acceptance and confidence that transforms rural women into powerful developmental tools to their household and communities. This may also lessen the burden of maternal deaths and reproductive health challenges emerging from the rural area. The effects of these ripples into gender equality, child health and survival and enhanced female educational outcomes that can reduce poverty. Considering the health disparities in the different segment of population, there is an urgent need to move towards the development of adaptive intervention and population disaggregation in the improvement of decision makings. This approach calls for investment in health information infrastructures which would provide more real time data to explore despite progress, there is the challenge of incomplete or non-existing data. It would require the intervention of South-South Cooperation (SSC) partnership to improve our health surveillance systems which would enhance the quality of data to evaluate the impact of interventions to track the progress on achieving the SDGs.