Leveraging Sociodemographic, Digital Exposure, and Knowledge-Based Empowerment Factors to Improve Maternal Health Behaviour Among Married Women in Nigeria: A Cross-Sectional Analysis of the 2018 NDHS

Abstract Background Maternal health behaviour is a key determinant of maternal and child health outcomes in Nigeria, yet disparities in the utilisation of essential services persist. While socioeconomic factors remain important predictors, the role of digital exposure and knowledge-based empowerment in shaping women’s health-seeking behaviour is increasingly recognised. This study examines the influence of sociodemographic characteristics, digital exposure, and knowledge-based empowerment on maternal health behaviour among married women in Nigeria, with implications for achieving Sustainable Development Goals (SDGs) 3 and 5. Methods This study analysed cross-sectional data from the 2018 Nigeria Demographic and Health Survey (NDHS). The sample comprised 28,888 women aged 15–49 years who were married or cohabiting and had a recent birth at the time of data collection. Outcome variables were the number of antenatal care (ANC) visits and the place of delivery for the most recent birth. Explanatory variables included sociodemographic characteristics, digital exposure indicators, and knowledge-based empowerment measures. Multivariable logistic regression models were used to estimate adjusted associations. Results ANC utilisation was significantly associated with age, education, wealth, residence, region, religion, household size, employment, occupation, and partner’s characteristics. Digital exposure variables (mobile phone ownership, internet use, frequency of use, and mobile financial transactions) were positively associated with ANC visits. Knowledge-based empowerment factors, including exposure to family planning information via SMS and social media, and key health knowledge indicators, were also significant predictors. Similar patterns were observed for place of delivery, with most sociodemographic, digital exposure, and knowledge-based empowerment variables significantly influencing the likelihood of facility-based delivery. Conclusions Digital exposure and knowledge-based empowerment complement traditional socioeconomic determinants of maternal health behaviour. Policies that expand digital access and strengthen women’s health knowledge, alongside efforts to reduce structural inequalities, are essential for improving maternal health service utilisation and accelerating progress toward SDGs 3 and 5 in Nigeria.