Abstract
Background Poor maternal health indices, including high maternal mortality, are among Nigeria's major public health problems. Most of these deaths can be prevented by timely access and utilization of maternity healthcare services by women. Aim/Objective. This study seeks to identify factors affecting the utilization of health facilities for the delivery of babies among mothers in Calabar, Cross River State, Nigeria. Methodology. The study was a community-based cross-sectional study. A structured questionnaire was administered to 422 women of reproductive age residents in the study area who had given birth at least once within the last five years prior to the survey using a multistage random sampling technique. Data generated were entered, coded, and analyzed using Statistical Packages for Social Sciences (SPSS version 22.0), and results were presented in tables and charts. Chi-squared tests and multiple logistic regression were used for the identification of variables associated with health facility-based delivery. Result The mean age of respondents was 27.3 years (SD = 8.4). Fifty-two percent of the respondents utilized the health facility for delivery, 89.6% attended at least one antenatal clinic (ANC), and 18.9% completed at least 3 ANC sessions. There was a statistically significant association between health facility delivery and marital status (P=0.007), education (P=0.042), and family size (P=0.002). Older women (OR = 0.7, CI = 0.169–3.714), Christians (OR = 1.9, CI = 0.093–41.1), divorcees (OR = 3.7, CI = 0.00–0.00), and respondents who registered early (first trimester) for ANC (OR = 4.9, CI = 0.78–31.48) were found to be higher users of delivery services at the health facility. Conclusion Community health intervention focusing on improving the knowledge and awareness of the significance of utilizing available delivery services at the healthcare facility should be developed and implemented.
Highlights
Complications during childbirth over the years have been largely responsible for most maternal deaths in the African region [1]. is is often exacerbated in poor-resource settings where access to maternal healthcare services is poor.Pregnancy and childbirth contribute to a low life expectancy of women in this region and constitute a significant threat to neonatal and infant survival [2].e World Health Organization (WHO) estimated that about 810 women die every day in 2017 from obstetric complications, and developing countries contribute 94% of Obstetrics and Gynecology International the total maternal death in the world [3]
Complications arising during labor, delivery, and the postpartum period largely account for most maternal mortality [6]. e WHO noted that 75% of maternal mortality is primarily caused by obstetric hemorrhage, hypertension in pregnancy, infection, obstructed labor, and unsafe abortion [7]
Most deliveries still occur at home without the assistance of a skilled birth attendant in developing countries [8]. us, there has been a noticeable decline in maternal deaths by 38% from 342,000 in 2000 to 211,000 in 2017, the annual reduction rate of 2.9% is less than the required target of 6.4% to achieve the Sustainable Development Goal of 70 maternal deaths per 100,000 live births [9]
Summary
Complications during childbirth over the years have been largely responsible for most maternal deaths in the African region [1]. is is often exacerbated in poor-resource settings where access to maternal healthcare services is poor. E World Health Organization (WHO) estimated that about 810 women die every day in 2017 from obstetric complications, and developing countries contribute 94% of Obstetrics and Gynecology International the total maternal death in the world [3]. In Nigeria, the Maternal Mortality Ratio (MMR) is currently 512 maternal deaths per 100,000 live births and is ranked the fourth highest globally [4, 5]. Available evidence has shown that health facility-based delivery of babies by skilled birth attendants can reduce maternal mortality [6]. Most deliveries still occur at home without the assistance of a skilled birth attendant in developing countries [8]. Delivery by skilled birth attendants was reportedly low, with 40% in Sub-Saharan Africa compared to 96% in developed countries [10]. The current study seeks to identify factors affecting the use of health facilities for childbirth among mothers in Calabar metropolis, Cross River State, Nigeria
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