FARMERS-HERDERS CONFLICT AND MATERNAL HEALTH SERVICE UTILIZATION IN RURAL NIGERIA: A SYSTEMATIC REVIEW

Abstract

Background: The persistent conflict between farmers and herders in rural Nigeria has emerged as a significant threat to public health, yet its specific impact on maternal health service utilization remains underexplored. This systematic review examines how the Farmers-Herders conflict affects maternal health service utilization in rural Nigeria, with particular focus on the North-Central and Middle Belt regions. Methods: A systematic review was conducted. Literature was retrieved from PubMed, Scopus, Web of Science, and Google Scholar. Eighteen studies met the inclusion criteria and were synthesized. Results: Findings show that the farmers-herders conflict significantly disrupts maternal health service utilization through both supply-side and demand-side pathways. Supply-side disruptions include destruction of health infrastructure, displacement of healthcare workers, and breakdown of medical supply chains. Demand-side barriers include insecurity-related fear, long travel distances, economic hardship, and restricted mobility. These factors collectively reduce antenatal care attendance, skilled birth delivery, and postnatal care utilization. Displaced populations experience additional barriers, including fragmented continuity of care and limited humanitarian support. Conclusion: The Farmers-Herders conflict constitutes a structural determinant of maternal health service utilization in rural Nigeria. Addressing this crisis requires multi-pronged interventions, including secure healthcare infrastructure, mobile health units, conflict-zone allowances for health workers, community-based support integration, and comprehensive maternal health services within humanitarian responses for displaced populations. Sustainable land governance and effective conflict resolution mechanisms are essential complements to health sector reforms.