Impact of Maternal Literacy on Child Health Outcomes in Zamfara State, North West Nigeria

Maternal literacy is a widely recognised social determinant of child health, influencing caregivers' capacity to navigate health systems, apply preventive practices, and respond to child illness appropriately. This cross-sectional analytical study examines the relationship between maternal literacy levels and child health outcomes in Zamfara State, North West Nigeria, where both female literacy and child health indicators rank among the lowest in the country. A total of 368 mother-child pairs were recruited from rural communities in Gusau and Talata Mafara local government areas. Maternal literacy was assessed using a standardised reading and numeracy test. Child health outcomes examined included nutritional status (BMI-for-age and height-for-age z-scores), immunisation coverage, and history of diarrhoea or acute respiratory infection in the preceding two weeks. Results demonstrated a significant positive association between maternal literacy and child nutritional status (p less than 0.01). Children of literate mothers had a 2.4-fold higher likelihood of being fully immunised. Maternal literacy was also associated with better recognition of danger signs and faster health-seeking behaviour. Fully literate mothers were more likely to use oral rehydration therapy appropriately. The findings provide quantitative evidence for the critical importance of girls' education as a long-term child health intervention. Recommendations include accelerating female functional literacy programmes and integrating health education into adult literacy curriculum. Keywords: maternal literacy, child health outcomes, Zamfara State, immunisation, North West Nigeria.