Determinants of the Utilization of Skilled Birth Attendance among Women in Ogun East Senatorial District, Nigeria: A Rural-Urban Comparison

Abstract

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.