Aktuelle Trends in der gynäkologischen Onkologie

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Determinants of skilled birth attendance utilization in rural area: Ahousehold survey in Northern Nigeria- Adewemimo A- Liverpool School of Tropical Medicine

Adewemimo A

Background: It has been well documented that Skilled Birth Attendance (SBA)is one of the key life-saving interventionsfor women during pregnancy, labour and delivery yet there is under-utilization of SBA in developing countries with the worst statistics in rural areas. However, the factors that enhance or militate against utilization of SBA are not fully explored. Objectives: To determine the levels, enablers and barriers for utilization of SBA Methods: A household survey was conducted in Funtua local government area, in Northern Nigeria from May-June 2012. Using multi stage sampling technique, 400 women of childbearing age who had their last delivery within two years preceding the studyincluded in the study. A structured questionnaire was used to asked questions about birth attendance during antenatal, delivery and postnatal period of their most recent birth and questions on enablers and barriers for SBA utilization. Logistic regression analysis was done to identify independent predictors of SBA. Findings: Of the 400women included in the study, 145(36.3%) received antenatal care from SBAs, 52(13%) had their births assisted by skilled personnel and 88(22%) received postnatal care from SBA. Maternal education, husbands occupation, presence of complications and previous place of birth were found to be statistically significant predictors for SBA utilization. Barriers to SBA utilization included lack of care provider, lack of equipment and supply, and poverty. Enablers included availability of staff, husbands permission and affordable services. Conclusion: Findings of this study show that women are more likely toutilize SBA with availability of skilled personnel, health system strengthening and intervention to remove user fees for maternal health services. Joint effort should be made by government and community leaders to encourage mens involvement in maternal health services.