Determinants of demand for skilled birth attendance among women of reproductive age in Kwara State, Nigeria

Abstract

The worldwide proportion of births attended by skilled health personnel has improved by 25 percentage points from 61 per cent in 2000 to 86 per cent in 2023. In sub-Saharan Africa, the figure rose from 43 per cent to 64 per cent over the same period: of the 675 pregnant women that received antenatal care services, only 53.1 per cent of urban and 24 per cent rural population utilised skilled birth attendants in Nigeria, which partly explains the high maternal mortality ratio in the country. Though studies have been conducted to investigate factors driving the demand for skilled birth attendant services, very few studies have investigated such determinants in Kwara State as far as our search indicated. A cross-sectional design was conducted from September to November 2019. A total of 933 women aged 15-49 years, who had delivered their last child in the five years before the survey were sampled from six randomly selected local government areas of Kwara State. A multistage sampling technique was used to select the sample, using a structured questionnaire. The study revealed that 28.90 per cent and 71.10 per cent of respondents were assisted by doctors and nurses/midwives respectfully. Over 22 per cent sought skilled delivery because of their perception of better pregnancy outcomes in the presence of trained personnel while over 39 per cent were influenced by their husbands. The study also revealed that maternal education, mass media exposure, marital status, and maternal occupation (formal sector employment) were the most significant factors that determined skilled birth attendance utilisation. The study, therefore, recommended policies and programmes designed like skills acquisition through vocational training and health education through multimedia campaigns should be adopted.