A Global Review of Care Experiences among Women in Rural Communities of Developing Countries, with Special Emphasis on Nigeria

Abstract

Rural women in developing countries continue to encounter maternal and reproductive health care that falls short of internationally recognised standards of dignity, respect and clinical quality. This narrative review synthesises evidence on the care experiences of rural women across low- and middle-income settings, with particular attention to Nigeria, the country carrying one of the world's largest absolute burdens of maternal mortality. Drawing on peer-reviewed qualitative, quantitative and mixed-methods literature, the review examines financial and geographic access barriers, interpersonal and respectful care dimensions, sociocultural determinants of health-seeking behaviour, workforce distribution, the persistent role of traditional birth attendants, digital health innovations and the disruptive effect of the COVID-19 pandemic on rural service utilisation. Findings indicate that rural women's care experiences are shaped by an interlocking set of structural, relational and cultural factors rather than any single deficiency. Disrespect and abuse during facility-based childbirth remain widespread across sub-Saharan Africa, out-of-pocket expenditure continues to deter timely care-seeking despite insurance reforms, and workforce shortages are disproportionately concentrated in remote areas. In Nigeria specifically, rural women navigate a plural care landscape combining formal biomedical services, traditional birth attendants and household negotiation, with quality of care, cost and cultural norms repeatedly cited as principal deterrents to facility use. Digital health interventions show promise but are constrained by unequal mobile phone ownership. The review concludes that improving rural women's care experiences requires simultaneous investment in workforce distribution, financial protection, respectful care standards and community engagement, rather than isolated technical fixes.