# The association of maternal education with access to maternal care and child mortality in Nigeria: A secondary data regression-based analysis

**Authors:** Chekwube Madichie, James Lomas, Luigi Siciliani

PMC · DOI: 10.1371/journal.pone.0337367 · PLOS One · 2026-02-05

## TL;DR

Higher maternal education in Nigeria is linked to lower child mortality and better access to maternal care, with effects influenced by socioeconomic and cultural factors.

## Contribution

This study quantifies the impact of maternal education on child mortality and maternal care access in Nigeria, using a robust statistical framework.

## Key findings

- Secondary education reduces under-five mortality by 2.08 ppt and increases maternal care access by 6.74 ppt.
- Socioeconomic factors modestly influence the education-mortality link but strengthen the education-care link.
- Literacy mirrors education's effects but does not independently affect outcomes in adjusted models.

## Abstract

Reducing under-five mortality and ensuring universal access to maternal healthcare are central goals of the Sustainable Development Goals (SDGs). Despite global progress, Nigeria continues to report one of the highest under-five mortality rates and the lowest access to maternal healthcare worldwide.

This study examines whether maternal education is associated with under-five mortality and access to maternal care in Nigeria. It also investigates whether these associations differ between rural and urban areas and whether they are explained by socioeconomic, ethnic, and religious factors. In addition, we assess whether literacy exerts an independent influence alongside formal education.

Using the 2021 Nigeria Malaria Indicator Survey (MIS) and a sample of 10,820 women of reproductive age, we employ a bivariate probit framework supplemented by propensity score matching (PSM) to examine the robustness of the findings.

Higher levels of maternal education, particularly secondary schooling, were significantly associated with a 2.08 ppt reduction in under-five mortality and a 6.74 ppt increase in access to maternal care. Economic status modestly attenuated the size of the education association with under-five mortality but strengthened it for maternal care, while ethnicity and religion partly explained the observed associations. Literacy displayed similar patterns to formal education when examined separately but did not retain an independent association with either outcome in fully adjusted models or when included alongside education. These findings are robust across alternative specifications.

Economically and culturally tailored policies that improve female educational attainment remain critical for enhancing access to maternal healthcare and reducing child mortality in Nigeria.

## Full-text entities

- **Diseases:** Neonatal disorders (MESH:D007232), -5 (MESH:D008232), DHS (OMIM:603663), under-five (MESH:D005166), diarrhoea (MESH:D003967), respiratory infections (MESH:D012141), complication (MESH:D008107), Malaria (MESH:D008288), deaths (MESH:D003643)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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## References

66 references — full list in the complete paper: https://tomesphere.com/paper/PMC12875495/full.md

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Source: https://tomesphere.com/paper/PMC12875495