Maternal Outcomes in the Context of Free Maternal Healthcare: Perception and Realities in Nigeria

Most maternal deaths are avoidable if quality life-saving interventions are available and accessible. However, inequality in access remains a major hindrance, particularly, in low and middle-income countries. Many countries introduced free maternal healthcare with the aim of addressing concerns about inequality and to improve the utilisation of skilled birth facilities in Sub-Saharan Africa. Despite this, inequality in access to maternal healthcare still persists. Some challenges related to policy implementation were identified as reasons for poor utilisation of maternal healthcare services; these challenges do not sufficiently explain why inequality persists. Using empirical literature this paper traces the barriers to maternal healthcare utilisation in low and middle-income countries and the various interventions to improving maternal health. Focusing on Nigeria this paper examines maternal outcomes in the context of free maternal healthcare. Specifically, this paper explores the impact of free maternal healthcare services on maternal healthcare utilisation, ideographic narratives related to free that could impinge on maternal healthcare utilisation and perception and experiences of users of free maternal healthcare services. In the main, the paper argues that barriers beyond financial exist and addressing issues related to culture and contextual differences might be crucial to reducing inequality in access to maternal healthcare.