Author(s): Nwakoby BN
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Abstract The pattern and determinants of maternal service utilization were studied in a rural Nigerian community. The study sample consisted of 488 randomly selected women who had a childbirth or an abortion between May 1987 and September 1989. Although 93\% registered for prenatal care in a health care institution, only 51\% delivered in a health institution while 49\% delivered at home mainly under the care of traditional birth attendants. Factors found to be most consistently associated with the use of health institutions for delivery were maternal education and occupation, religion, and occupation of the husband. Maternal age, parity and marital status and place of the residence were not significantly associated with the choice between home and institutional delivery. Logistic regression analysis was used to determine the odds ratio and to quantify the weight of these independent variables found to be significantly associated with the place of delivery as the outcome variable. PIP: A community survey of 488 women was conducted among 22 out of 59 villages in Obukpa town, Nigeria, during May 1987 and July 1989. Information was collected on demographic and socioeconomic characteristics of those registered for prenatal care and those delivering at home or in a health center. The study population was primarily agricultural with low levels of education and was predominately Christian. 17\% were in polygamous marriages, 93\% were registered for prenatal care, 51\% delivered in a health institution, and 49\% delivered at home. Home deliveries were primarily among farm families with civilian nonemployed mothers in polygamous unions. Residence location did not affect place of delivery, but respondents all lived within 5 km of a health institution. In the logistic model, education and occupation of the mother, religion, and husband's occupation were significantly associated with delivery at a health institution. The likelihood of a health care institution delivery tripled among mothers with postprimary education compared to mothers with no schooling. There was a 1.7 times higher likelihood of institutional delivery among mothers in petty trades and a 2.3 times higher probability among farming women than women with no occupation. There was a 2.3 times higher probability of a health care institution delivery with a Christian mother. Marriage to a civil servant increased the probability of health institution delivery by 2.2 times.
This article was published in J R Soc Health
and referenced in Journal of Pregnancy and Child Health