{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:14:27Z","timestamp":1791231267246,"version":"4.1.0"},"reference-count":79,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Explicit and implicit cultural patterns are critical cultural norms, beliefs, and practices that determine women\u2019s health-seeking behaviour. These cultural patterns could limit women\u2019s use of maternal health services, resulting in maternal health complications. The study aims to provide an in-depth understanding of explicit and implicit cultural patterns, their meanings and how they influence women\u2019s use of maternal health services among Igala women in Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Roper and Shapira\u2019s (2000) focused ethnography was employed with 43 women aged 18\u201343 years recruited using the purposive and snowballing technique. The study was conducted with 21 women for one-on-one interviews and two focus group discussions with six women in the rural area and seven women in the urban area. In addition, participant observation of nine women from the third trimester to birth was conducted, yielding 189\u00a0h of observation in two primary healthcare facilities in rural and urban areas. Data analysis was conducted using Roper and Shapira\u2019s (2000) method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Three themes were generated using the PEN3 cultural model: perceptions, enabler, and nurturers. Subthemes generated under the theme of perception were, Belief in witchcraft, Pregnancy announces itself, I cannot tell people I am in labour, and Unspoken acquiescence to the culture. Under the theme of nurturer, Home birth was found to limit access to maternal health services. The theme of enabler yielded subthemes such as You are not woman enough; I want my placenta and Rising matriarchs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implicit and explicit cultural patterns significantly influence women\u2019s use of maternal health services. Given the complexity of culture and its influence on women\u2019s use of maternal health services, multifaceted strategies tailored to the cultural needs of communities are needed to enhance the realization of Sustainable Development Goal #3:1\u00a0in Nigeria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-025-21275-9","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T06:10:14Z","timestamp":1736748614000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Visible and invisible cultural patterns influencing women\u2019s use of maternal health services among Igala women in Nigeria: a focused ethnographic study"],"prefix":"10.1186","volume":"25","author":[{"given":"Uchechi Clara","family":"Opara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peace Njideka","family":"Iheanacho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pammla","family":"Petrucka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"issue":"1","key":"21275_CR1","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12978-021-01151-6","volume":"18","author":"S Omer","year":"2021","unstructured":"Omer S, Zakar R, Zakar MZ, Fischer F. 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