Determinants of the Utilization of Skilled Birth Attendance among Women in Ogun East Senatorial District, Nigeria: A Rural-Urban Comparison
DOI:
https://doi.org/10.30442/ahr.1003-05-245Keywords:
Childbirth, Healthcare Providers, Utilisation, Skilled Birth Attendants, Women, Rural-Urban ComparisonAbstract
Background: Every woman needs access to skilled care during pregnancy, childbirth, and the following weeks. Recent estimates show that the proportion of deliveries attended by a skilled attendant in many African countries remains low.
Objective: To identify the determinants of utilising skilled birth attendance (SBA) among women in Ogun East Senatorial District of Nigeria.
Methods: A comparative, cross-sectional study was conducted among 375 women in each rural and urban community selected using multistage sampling. A pretested interviewer-administered, structured questionnaire was used for data collection.
Results: A higher proportion of urban respondents (67.7%) utilised SBA compared to rural respondents (53.6%), p<0.001. The determinants of utilisation of SBA services included proximity and means of transportation to the facility (p<0.001). On multivariate analysis, health problems in the preceding pregnancy (AOR = 8.183, 95% CI = 2.621-25.545) and spousal support (AOR = 6.909, 95% CI = 2.013-23.705) remained significant determinants of utilisation of SBA in the rural area but not in the urban area.
Conclusion: Rural dwellers face significant barriers in accessing the services of skilled birth attendance. Improving transportation infrastructure, engaging spouses in maternal health education and managing health problems during pregnancy could enhance SBA utilisation and reduce rural-urban disparities.
References
World Health Statistics 2016: Monitoring health for the SDGs [Internet]. [cited 2020 15 March]. Available from: https://www.who.int/gho/publications/world_health_statistics/2016/Annex_B/en/
WHO, ICM, FIGO. Making pregnancy safer: The critical role of the skilled attendant [Internet]. Available from: https://www.who.int/maternal_child_adolescent/documents/9241591692/en/
WHO. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division [Internet]. WHO; 2015 [cited 2020 21 February]. Available from: https://www.afro.who.int/sites/default/files/2017-05/trends-in-maternal-mortality-1990-to-2015.pdf
WHO. Definition of skilled health personnel providing care during childbirth: the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA, 2018 [Internet]. [cited 2020 16 March]. Available from: https://apps.who.int/iris/bitstream/handle/10665/272818/WHO-RHR-18.14-eng.pdf?ua=1
World health statistics 2019: Monitoring for the SDGs [Internet]. [cited 2020 21 February]. Available from: https://www.who.int/gho/publications/world_health_statistics/2019/en
Adewemimo AW, Msuya SE, Olaniyan CT, Adegoke AA. Utilisation of skilled birth attendance in Northern Nigeria: A cross-sectional survey. Midwifery [Internet]. 2014 [cited 2021 16 February];30:e7–e13. Available from: https://www.sciencedirect.com/science/article/pii/S0266613813002866
National Population Commission, ICF. Nigeria Demographic and Health Survey 2018 - Final Report. Abuja, Nigeria and Rockville, Maryland, USA; NPC and ICF; 2019.
Singh K, Brodish P, Suchindran C. A Regional Multilevel Analysis: Can Skilled Birth Attendants Uniformly Decrease Neonatal Mortality? Matern Child Health J [Internet]. 2014 [cited 2021 16 February];18:242–249. Available from: https://link.springer.com/article/10.1007%2Fs10995-013-1260-7
Yakoob MY, Ali MA, Ali MU, Imdad A, Lawn JE, Van Den Broek N, et al. The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths. BMC Public Health [Internet]. 2011 [cited 2021 16 February];11:S7. https://doi.org/10.1186/1471-2458-11-S3-S7
WHO. WHO recommendations on health promotion interventions for maternal and newborn health 2015 [Internet]. [cited 2020 18 March]. Available from: https://www.who.int/maternal_child_adolescent/documents/health-promotion-interventions/en/
Budu E, Chattu VK, Ahinkorah BO, Seidu AA, Mohammed A, Tetteh JK, et al. Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa. BMC Pregnancy Childbirth [Internet]. 2021 14 December [cited 2024 7 August];21(1):834. https://doi.org/10.1186/s12884-021-04280-9
Oni B, Odukoya O, Okunowo A, Ojo O, Abatan Y. A comparative assessment of the awareness of danger signs and practice of birth preparedness and complication readiness among pregnant women attending rural and urban general hospitals in Lagos State. Sahel Med J [Internet]. 2016 [cited 2021 16 February];19:206–214.
Solanke B, Rahman S. Multilevel analysis of factors associated with assistanceduring deliveryin rural Nigeria: implications for reducing rural-urbaninequality in skilled care at delivery. BMC Pregnancy Childbirth [Internet]. 2018 [cited 2021 16 February];18:438. Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-2074-9
Idowu A, Olowookere SA, Abiola OO, Akinwumi AF, Adegbenro C. Determinants of Skilled Care Utilisation among Pregnant Women Residents in an Urban Community in Kwara State, Northcentral Nigeria. Ethiop J Health Sci. 2017;27:291–298. https://doi.org/10.4314/ejhs.v27i3.11
WHO. A systematic review of inequalities in the use of maternal healthcare in developing countries: examining the scale of the problem and the importance of context [Internet]. [cited 2020 20 April]. Available from: https://www.who.int/bulletin/volumes/85/10/06-035659/en
Saaka M, Akuamoah-Boateng J. Prevalence and Determinants of Rural-Urban Utilization of Skilled Delivery Services in Northern Ghana. Scientifica. 2020;2020(1):1–13. https://doi.org/10.1155/2020/9373476
Olowokere AE, Oyedele AT, Komolafe AO, Olajubu AO. Birth preparedness, utilisation of skilled birth attendants and delivery outcomes among pregnant women in Ogun State, Nigeria. Eur J Midwifery [Internet]. 2020 [cited 2021 16 February];4:22. https://doi.org/10.18332%2Fejm%2F120116
Smeele P, Kalisa R, van Elteren M, van Roosmalen J, van den Akker T. Birth preparedness and complication readiness among pregnant women admitted in a rural hospital in Rwanda. BMC Pregnancy Childbirth [Internet]. 2018 [cited 2021 Feb 16];18(1):190. Available from: https://doi.org/10.1186/s12884-018-1818-x
Akshaya KM, Shivalli S. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India. PLOS ONE [Internet]. 2017 [cited 2021 16 February];12:e0183739.
Gwacham-Anisiobi UC, Banke-Thomas A. There is no ideal place, but it is best to deliver in a hospital: expectations and experiences of health facility-based childbirth in Imo State, Nigeria. Pan Afr Med J [Internet]. 2020 [cited 2021 16 February];36:317.
Nwankwo ONO, Ani OE, Akpoke M, Ugwa EA. Determinants of Choice of Place of Delivery among Women Attending Two Referral Hospitals in Kano North-West Nigeria. Niger Med J J Niger Med Assoc [Internet]. 2019 [cited 2021 16 February];60:68–75.
OSLG. Ogun State Local Government [Internet]. [cited 2021 5 May]. Available from: https://ogunstatebiz.tripod.com/adoodootalocalgovernment/id20.html
National Bureau of Statistics. 2017 Demographic statistics bulletin [Internet]. [cited 2020 16 May]. Available from: www.nigerianstat.gov.ng
How to Calculate Population Projections [Internet]. Sciencing. [cited 2021 9 December]. Available from: https://sciencing.com/calculate-population-projections-8473012.html
Ogun State Ministry of Health. Ogun State Health Bulletin 2010 [Internet]. [cited 2020 13 March]. Available from: www.mamaye.org.ng
Taylor D. The calculation of sample size and power in the planning of experiments. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Ontario, Canada; 1983.
John Hopkins Bloomberg School of Public Health Center for Communication Programs, Family Care International, Maternal and Neonatal Health. Monitoring Birth Preparedness and Complication Readiness: Tools and indicators for maternal and newborn health. JHPIEGO; 2004.
Ekabua JE, Ekabua KJ, Odusolu P, Agan TU, Iklaki CU, Etokidem AJ. Awareness of Birth Preparedness and Complication Readiness in Southeastern Nigeria. ISRN Obstet Gynecol [Internet]. 2011 [cited 2021 16 February];2011:560641. https://doi.org/10.5402/2011/560641
Tobin EA, Ofili AN, Enebeli N, Enueze O. Assessment of birth preparedness and complication readiness among pregnant women attending Primary Health Care Centres in Edo State, Nigeria. Ann Niger Med [Internet]. 2014 [cited 2021 16 February];8:76–81.
Adams C. The Meds and Eds in Urban Economic Development. J Urban Aff [Internet]. 2003 1 December [cited 2021 9 December];25:571–588. Available from: https://doi.org/10.1111/j.1467-9906.2003.00003.x
Gudu W, Addo B. Factors associated with utilisation of skilled service delivery among women in rural Northern Ghana: a cross-sectional study. BMC Pregnancy Childbirth [Internet]. 2017 [cited 2021 16 February];17:159. https://doi.org/10.1186/s12884-017-1344-2
Ogboghodo E, Adam V, Omuemu V, Okojie O. Knowledge, attitude, and utilisation of skilled birth attendants in a rural community in Southern Nigeria: A mixed method survey. Int J Med Sci Public Health. 2019;8:61–70.
Yaya S, Okonofua F, Ntoimo L, Udenige O, Bishwajit G. Gender inequity as a barrier to women’s access to skilled pregnancy care in rural Nigeria: a qualitative study. Int Health [Internet]. 2019 Nov 13 [cited 2024 May 23];11:551–560. https://doi.org/10.1093/inthealth/ihz019
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