Utilization of skilled birth attendants at delivery among urban women in Nnewi Nigeria

Abstract

Background: Maternal mortality ratio remains high in Nigeria and the Presence of skilled birth attendants at delivery is a key strategy towards reducing the rate.

Objective: To determine the rate and factors that affect utilization of skilled birth attendants (SBA) among Igbo women in Nnewi, South-Eastern Nigeria

Methodology: A cross sectional survey of 400 market women using semi structured questionnaires and focus group discussions.

Results: The rate of utilization of SBAs at birth was 88.4%. Majority (72.8%) of the women delivered in the private health facilities while 15.6% delivered in a government health facility. Majority of the women who did not assess SBAs at their last delivery, delivered in the maternity homes (65.2%), followed by Traditional Birth Attendant's place (26.1%; n=12). The main reasons for non-utilization of SBA at delivery were the long distance to the health facilities (65.0%), exorbitant hospital fees (34.8%), culturally unacceptable hospital practices (32.6%) and unfriendly attitude of the hospital staff (26.1%).

Women aged 24-29 years(X²=25.84; P=0.00) and those who had attained tertiary education (X²=8.39; P=0.03) were significantly more likely to utilize SBAs at delivery than the other women Marital status (X²=1.42; P=0.48), occupation (X²=7.34; P=0.12) and religion (X²=0.87; P=0.92) did not significantly affect the utilization of SBAs at delivery.

Most focus group discussants indicated that distant location of the hospitals; high cost of services and the unfriendly attitude of the workers were the major reasons for not utilizing SBAs at deliveries.

Conclusion: There is a good rate of utilization of SBAs among Igbo women in Southeast Nigeria. There is need for even distribution of health facilities and reduction in the cost of services to further improve the rate of utilization

Keywords: Antenatal care, Place of delivery, Postnatal services, Nurses, Maternity homes