Macroeconomic Conditions and Maternal Mortality in Nigeria: Asymmetric Evidence from a Nonlinear Ardl Technique

Abstract

Maternal mortality continues to be one of the most enduring public health problems in Nigeria, despite decades of economic reforms and health sector responses. Macroeconomic conditions are well known to be important determinants of health outcomes, yet little empirical evidence exists on how economic fluctuations influence maternal mortality, especially in developing countries. The study examines the asymmetric influence of key macroeconomic variables: economic growth, inflation, and unemployment on maternal mortality in Nigeria between 1986 and 2023. Drawing on the preston curve and the economic opportunity theory, the study employs the nonlinear autoregressive distributed lag (NARDL) technique to estimate short-run and long-run dynamics while differentiating between positive and negative macroeconomic shocks. The results indicate substantial nonlinearities: adverse macroeconomic shocks are associated with higher maternal mortality, particularly through rising inflation and unemployment, while gains in macroeconomic conditions yield comparatively weaker effects. Health system factors, such as prenatal care coverage and the quality of institutions, buffer these effects to a degree but still prove inadequate under unstable economic conditions. The findings suggest that Nigerian maternal survival is highly sensitive to macroeconomic volatility. The study therefore highlights the need for coordinated macroeconomic stabilization, provision of maternal health services, and institutional strengthening in order to realize sustained reduction in maternal mortality and accelerate progress towards Sustainable Development Goal 3.