Women In Enugu Research Articles

Seroprevalence of Human Immunodeficiency Virus, Hepatitis B, Hepatitis C, Syphilis, and Co-infections among Antenatal Women in a Tertiary Institution in South East, Nigeria.

Background:Sexually transmitted infections and human immunodeficiency virus (HIV)/AIDS are a major public health concern owing to both their prevalence and propensity to affect offspring through vertical transmission.Aim:The aim was to determine the seroprevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and co-infections among antenatal women in Enugu, South-East Nigeria.Materials and Methods:A retrospective study of antenatal women at the University of Nigeria Teaching Hospital, Enugu, South-East Nigeria from 1st May 2006 to 30th April 2008. A pretested data extraction form was used to obtain data on sociodemographic variables and screening test results from the antenatal records. The analysis was done with SPSS version 17 (Chicago, IL, USA).Results:A total of 1239 antenatal records was used for the study. The seroprevalence of HIV, HBV, HCV, and syphilis among the antenatal women were 12.4% (154/1239), 3.4% (42/1239) 2.6 (32/1239) 0.08% (1/1239), respectively. The HIV/HBV and HIV/HCV co-infection prevalence rates were 0.24% (3/1239), 0.16% (2/1239), respectively. There was no HBC and HCV co-infection among both HIV positive and negative antenatal women. There was no statistically significant difference in HBV and HCV infection between the HIV positive and negative antenatal women. The only woman that was seropositive for syphilis was also positive to HIV.Conclusion:The seroprevalence of HIV, HBV, HCV, and syphilis is still a challenge in Enugu. Community health education is necessary to reduce the prevalence of this infection among the most productive and economically viable age bracket.

Enhancing Social Network Status and Empowerment of Rural Nigerian Women through Non-Formal Education

The study examined the extent participation in non-formal education programmes improved social networking and empowerment of rural women in Nigeria. One research question and one hypothesis guided the study. Survey research design employing stratified random sampling was used to sample 1668 rural women from Enugu and Plateau States who participated in the Women for Women International’s Non-formal Education programme, out of which 1558 responded to the study. Questionnaire was used for data collection. The questionnaire was face validated by experts in the field of education, a reliability co-efficient of 0.76 was obtained using cronbach alfa method of determining internal consistency of instrument. The research question was answered using mean and grandmean while the hypothesis was analysed using t-test statistics. The result revealed that participation in non-formal education programmes improved social network status and empowered rural women in Nigeria. Significant differences existed in the mean response of rural women in Enugu and Plateau states on the extent participation in non-formal education programme improved their social network status. It was recommended among other things that Renewing Women’s Lifeskill education prorgamme should be inculcated into women education programme of the National Policy on Women Education in Nigeria. DOI: 10.5901/ajis.2013.v2n5p35

Cervical Cancer Screening among HIV-Positive Women in Nigeria

The sustainability of donor-supported cervical cancer screening for HIV-positive women in underresourced setting is a concern. The authors aimed to determine the willingness of HIV-positive women for out-of-pocket payment for the cancer screening, if necessary. Questionnaires were administered to 400 HIV-positive women at the Adult HIV clinic, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. In all 11 (2.8%) respondents were aware of Pap smear, but only 1 (9.1%) of them had used it. After cervical cancer screening counseling, 378 (94.5%) respondents were willing to pay for Pap smear, irrespective of the cost. This willingness showed no trend across marital or educational groups. Younger age of respondents was not associated with willingness to pay for Pap smear (odds ratio = 1.24; confidence interval 95%: 0.52, 2.94). Willingness to pay for Pap smear by HIV-positive women in Enugu, Nigeria, is high. This has implication for the program sustainability.

Duration and determinants of inter-birth interval among women in Enugu, south-eastern Nigeria

The difference in fertility levels of any given two societies has a relationship with the interval between births. We determined the duration of inter-birth interval and the determinants of short inter-birth interval in Enugu, Nigeria. Questionnaires were administered to a cross-section of 420 women consecutively recruited from the family planning and antenatal clinics of two hospitals in Enugu metropolis. The mean age was 30.9 ± 5.1 (range 20–44) years. The median inter-birth interval was 21.5 months and the prevalence of modern contraceptive use among respondents was 18.1%. Women's age of 25 years or less, duration of breast-feeding of 10 months or less, and non-use of modern contraceptives had strong association (p < 0.05) with short inter-birth interval. The mean inter-birth interval in Enugu is short. Future child spacing campaign in Enugu should target the encouragement of longer breast-feeding practices and increased uptake of modern contraception among our women.

Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria

The goal of roll back malaria partnership is to achieve universal coverage for all populations at risk using appropriate interventions for prevention and case management. The objective of this study is to determine the use of insecticide treated nets (ITNs) and other anti-vector measures among pregnant women in an area hyper-endemic for malaria. Questionnaires were administered to a cross-section of 832 consecutive pregnant women attending antenatal care in three hospitals in Enugu, Nigeria that have high client flow for maternity services. Data collected were analyzed using descriptive and inferential statistics by means of the Statistical Package for Social Sciences (SPSS) version 16. P-value of less than 0.05 was considered statistically significant. The mean age of the women was 33.2 ± 2.9 (range: 15-45) years. Three hundred and fifty nine (43.1%) women owned insecticide treated nets (ITNs), however 325(90.5%) slept under the nets during the index pregnancies; equivalent to 39.1% utilization rate among the 832 women studied. Out of the 325 (39.1%) women that used ITNs; 236 (28.4%) used it singly, while 89 (10.7%) used it in combination with other anti-vector measures. Educational status and social class of the women had strong association with the use of ITNs (P < 0.0001). Women who used ITNs were significantly less likely to have acute malaria, anaemia and babies with low birth weight than women who did not use ITNs (P < 0.05). The use of ITNs is poor among pregnant women in Enugu, but associated with favorable maternal and feto-neonatal outcome. Future measures to increase its use should consider improvement in educational level and social class of our women.

Postpartum Practices of Parturient Women in Enugu, South East Nigeria

Background:Postpartum period is an important and interesting period in the life of the nursing mothers. It is a medically neglected period that receives relatively less attention than pregnancy and delivery.Aim:To describe the postpartum practices of women in Enugu, South East Nigeria.Subject and Methods:This was a cross sectional study of women attending the postnatal care clinic at the UNTH, Enugu. Data was abstracted and analyzed with statistical software for social sciences version 12.0. The results were presented by percentages. Binomial logistic regression was used to determine the association between some socio-demographic variables and resumption of coitus. P value less than 0.05 was considered statistically significant.Results:Out of the 420 mothers, 68.9% (289/420) resumed coitus within 6 weeks of delivery. Only 14.7% (62/420) used contraception before resumption of coitus. There was no significant association when the model was adjusted for age (OR, 1.132, 95% CI (0.691-1.867), P = 0.612.), Parity (OR, 1.273, 95% CI (0.812-1.996), P = 0.292) and education (OR, 0.713, 95% CI (0.433-1.173), P = 0.183). Twenty five percent [25.2% (106/420)] of the women drank various forms of alcoholic beverages to induce lactation while 80.2% (337/420) of the women applied hot compresses on the lower abdomen to aid lochia drainage and involution of the uterus, 75% (315/420) of the women sat in hot water salt (Nacl) solution (sitz bath) in the immediate postpartum to aid lochia drainage, aid perineal wound healing and improve vaginal tone.Conclusion:There is need for medical attention and education on beneficial postpartum practices among women in Enugu, South East Nigeria. Thus, to reduce the associated maternal morbidities in the postpartum period.

The prevalence of Rhesus negativity among pregnant women in Enugu, Southeast Nigeria

Hemolytic disease of the newborn, secondary to rhesus D (Rh D) iso-immunization, contributes significantly to perinatal morbidity and mortality. Prevalence data in Nigeria, and Southeast Nigeria in particular, is very scanty. This study was carried out to provide our experience in this preventable clinical condition in Enugu, Southeast Nigeria. To determine the prevalence and trends of Rh D negativity among pregnant women in Enugu, Southeast Nigeria. A 5-year retrospective study of rhesus negative women was carried out at the University of Nigeria Teaching Hospital, Enugu, Nigeria, between 1 st January 2000 and 31 st December 2004. The prevalence rate of Rh D negative women in Enugu, Nigeria, is 4.5%. Out of 6306 women who booked for antenatal care, 282 (4.5%) were Rh D negative women. One hundred and eighty-two (182) (64.5%) of the Rh D negative women were of blood group O followed by blood group A 20%, blood group B 12.1%, and blood group AB 3.2%, respectively. There is a need for adequate counseling of pregnant women on the importance of Rh D negative factor during the antenatal period in order to prevent hemolytic disease of the newborn.

The Effect of Gravidity on Anthropometric Indices of Pregnant Women in Enugu, South East, Nigeria.

Anthropometry in pregnancy is a comparative measure of size, proportion and composition of the body in relation to pregnancy. Anthropometric indices are useful in the assessment of nutritional status of pregnant women and predicting pregnancy outcome. To determine the effect of gravidity on anthropometric indices of pregnant women in Enugu, South East Nigeria. This was a prospective cross sectional survey of 578 pregnant women drawn from the general population of Enugu metropolis of Nigeria. These women were randomly selected from antenatal care attendees from four peripheral hospitals in Enugu. A self-administered structured pretested questionnaire was designed. The data were analyzed by descriptive and inferential statistics using SPSS version 12, and P value less than 0.05 was considered statistically significant. The mean values of the weight, body mass index (BMI), mid upper arm. Circumference (MUAC), calf circumference (CC), waist circumference and hip circumference of pregnant women in Enugu increased significantly from primigravida to those in their forth pregnancy (P 0.05). Multigravid women have higher anthropometric indices in Enugu, Nigeria. There is need for education/enlightenment about reduction in weight gain during pregnancy after delivery. Keywords : Gravidity, Anthropometric indices, pregnancy, Enugu-Nigeria.

Prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Enugu, South-eastern Nigeria

HIV infection is a risk factor for cervical cancer and both diseases are prevalent in Nigeria. The study determined the prevalence of cervical squamous intraepithelial lesion (SIL) among HIV-positive women in Enugu state, which has the highest HIV burden in South-eastern Nigeria. Pap smear was carried out on 150 HIV-positive (HIV+ve) women and 150 HIV-negative (HIV–ve) controls at the University of Nigeria Teaching Hospital, Enugu, Nigeria from December 2007 to March 2008. The prevalence of SIL for the HIV+ve group and the control group were 12.6% and 4.6%, respectively (p = 0.014). Also, the prevalence of each category of SIL identified in the study, was higher among the HIV+ve group. There is an association between HIV infection and SIL in Enugu, South-eastern Nigeria. Cervical cancer screening should be incorporated into the antiretroviral (ARV) clinics, so as to prevent the impending surge in the burden of cervical cancer in Nigeria.

Copper and selenium status of healthy pregnant women in Enugu, southeastern Nigeria

Copper and selenium are important trace elements in man. They function as antioxidants and play roles in oxido-reductase reactions. Several imported multivitamin preparations are given to our women during pregnancy and lactation to correct possible deficiencies. The aim of the study is to determine the serum level of these micronutrients (selenium and copper) in a cross section of pregnant women in Enugu, southeastern Nigeria. A cross section of 130 healthy pregnant women at different trimesters of pregnancy and 30 non-pregnant controls were selected from two health facilities in Enugu, southeastern Nigeria. Serum from the samples collected was assayed for copper and selenium using atomic absorption spectrophotometer. The mean copper level increased (P = 0.018), while the selenium level decreased (P < 0.0001) as pregnancy advanced. High copper levels indicate that supplementation should not be undertaken during normal pregnancy. Dietary intake should be modified to ensure optimal selenium levels during pregnancy.

The influence of parity on the gestational age at booking among pregnant women in Enugu, south east Nigeria

Antenatal care utilization is influenced by several factors. Due to our peculiar socioeconomic and cultural circumstances, gestational age at booking may be affected by certain variables. The aim of this study was to determine the influence of parity and other socio demographic factors on gestational age at booking amongst pregnant women in Enugu, South Eastern Nigeria. This is a prospective multicenter survey of randomly selected 928 pregnant women attending antenatal care for the first time in three hospitals in Enugu between January 1, 2006 to December 31, 2007. The average age was 30.22 +/- 5.2 years. The average age of the primigravidae at booking was 29.16 +/- 5.6 years.The average gestational age at booking for all the pregnant women studied was 26.12 +/- 7.6 weeks. Parity significantly [P < 0.05] influenced the gestational age at booking. Parity age for primagravidae group was 24.0 +/-7.9 weeks. Parity age for multigravidae was 27.16 +/- 7.5 weeks while for grandmultiparous women it was 26.12 +/- 7.6 weeks. Occupation did not have significant influence on gestational age at booking. It is concluded that parity significantly influenced the gestational age at booking in Enugu.

Awareness of mammography and breast self-examination: a survey

The aim of the study was to assess the level of awareness of the women in Enugu, South-Eastern Nigeria about breast cancer, mammography and breast self-examination (BSE). A crosssectional prospective survey that targeted women between 17 and 40 years old was conducted. The survey instrument was a 13-item self-completion questionnaire distributed to the respondents directly. There was high level of awareness about breast cancer (72%, n=212). The level of awareness about breast cancer was significantly positively influenced by respondents' level of education (P&gt; 0.05). The level of awareness about mammography was low (25%, n=75) and was significantly positively influenced by respondents' level of education. The awareness about breast self-examination was encouraging (56%, n=166) but regular practice of breast self-examination was not as encouraging (45%, n=132). The awareness about breast self-examination was matched by the same level of awareness about breast cancer presenting sometimes as a painless breast lump (56%, n=166 vs 57%, n=168; P&gt; 0.05). The television was the major source of the respondents' information about breast cancer, breast self-examination and mammography. Awareness of breast cancer and breast self-examination among the women in South-Eastern Nigeria is encouraging but their level of awareness about mammography is poor. Education plays an important role in breast cancer awareness and its aggressive pursuit is recommended.

Emergency contraceptive knowledge and practice among unmarried women in Enugu, southeast Nigeria.

With a high incidence of unwanted pregnancies and unsafe abortion especially among unmarried women in developing countries, there is need to promote emergency contraception (EC). To assess the unmarried women's knowledge, attitude and practice of EC. A random sample of a cross-section of 594 unmarried women in Enugu, southeast Nigeria, was surveyed with questionnaire between January and April 2004. Of the 1,160 unmarried women interviewed initially, 51% had heard of EC. One hundred (16.9%) knew the correct meaning of EC and these were mainly those with higher educational qualification, previous unwanted pregnancy, or had used modern contraception (p<0.05). Other respondents mentioned vaginal douching, application of traditional remedies to the vagina as effective emergency contraceptives. Although sixty percent (n=354) of respondents had used regular modern contraception, only 20% (n=119) had ever used EC. Few respondents knew correctly how EC function and the recommended timeframe for use. The two most common sources of information about EC were mass media (49.2%) and friends (28.8%). Seventy three percent (n=87) of emergency contraceptive users had some difficulties obtaining EC due to non-availability (n=42), attitude of health service providers to unmarried women demanding contraception (n=28) and cost (n=17). The attitude of the health service providers may have accounted for the dearth of information on EC even among users. Sixty-seven percent of respondents favored the use of EC by unmarried women. Opposition to the use of EC by unmarried women is because ofbeliefthat it has some health effect (n=72), induces abortion (n=80) and for religious reasons (n=42). Provision of appropriate information and access to EC, better service providers' attitude towards unmarried women is advocated.

Distribution of haemoglobin genotypes and anaemic status of HIV positive pregnant women in Enugu: a hospital based study

This present 4 – year comparative study investigated the distribution pattern of Haemoglobin genotypes and anaemic status of HIV positive pregnant women in Enugu. Haemoglobin variants(HbAA, HbAS, HbSS) in pregnant women attending antenatal clinics at the study site were determined by electrophoreisis. HIV screening tests were done using the Quick test kits. Packed Cell Volume (PCV) was estimated by using standard procedures. Results showed a prevalence rate of 83.3% was obtained for HbAA HIV+ pregnant women as against a 70.1% for HIV- pregnant women; HbAS rates were 16.7% for HIV+ pregnant women and 29.9% for HIV- pregnant women. For the non- pregnant women (control), the rates were 78.63% for HbAA and 21.4% for HbAS. No HbSS genotype was observed in the HIV+ pregnant women and HIV- pregnant women and the control respectively. The HIV seroprevalence rate of 3.67 +- 0.40%(SEM) was obtained for this study. The PCVs of the HIV+ pregnant women with HbAA and HbAS (1999 – 2002) fell into levels indicative of anaemia when compared with those of HIV- pregnant women and the control. Increased awareness, compulsory pre-marital sickling and HIV tests could be the possible reason for the low HIV seroprevalence and the absence of HbSS observed in this population. Nigerian Journal of Health and Biomedical Sciences Vol. 7 (1) 2008 pp. 27-30

Participation in highly subsidised cervical cancer screening by women in Enugu, South-east Nigeria

SummaryThe current study was designed to evaluate the level of participation in a highly subsidised cervical screening in a resource-poor country. A total of 989 cervical smears performed on 932 women in Enugu, south-east Nigeria, over a 10-year period (January 1995 – December 2004) was reviewed. The level of participation in cervical screening was very low, as <1% of the targeted women population participated. Almost 68% of the participants were referred for the screening and the majority (52.3%) were from lower social classes because the programme was highly subsidised. A total of 646 (65.3%) smears were normal. Of the abnormal smears, 193 (19.5%) had non-specific inflammatory changes, 136 (13.8%) showed dyskaryotic cells while 14 (1.4%) had neoplastic changes. A total of 57 (6.1%) women had more than one cervical cancer screening and they were characterised by increasing age, up to 59 years, higher social classes and contraceptive users in lower social classes. To reverse the low level of participation in cervical cancer screening in developing countries, there is a need to provide highly subsidised (if not free) cervical cancer screening services, which must be followed by sustained cervical cancer awareness campaign.

Pregnancy outcome in HIV-positive women in Enugu, Nigeria

SummaryThis is a retrospective case-control study of 62 HIV-positive women and 100 HIV-negative controls who delivered in the University of Nigeria Teaching Hospital, Enugu, from 2 August, 2002 to 31 March, 2004. The HIV-positive women were relatively younger and of lower mean parity than the HIV-negative controls. They were also significantly more likely to have positive syphilis serology, higher mean duration of labour, perineal tear, puerperal sepsis and higher mean duration of hospital stay, higher prevalence of low birth weight, birth asphyxia and more admissions to the Newborn Special Care Unit than the controls (p < 0.05). However, there was no significant difference in the two groups in the prevalence of hepatitis B surface antigenaemia, recurrent vulvovaginitis, abortions, stillbirths, congenital anomalies, pre-term delivery, mean interval between rupture of membranes and delivery and mode of delivery (p > 0.05). All (100%) the HIV-negative and 96.8% of the seropositive women had voluntary counselling and testing (VCT). There was no maternal death in either group. Untreated maternal HIV infection is associated with adverse pregnancy outcomes in the form of increased maternal and fetal morbidities. Hence for optimal outcomes, prevention of mother-to-child transmission (PMTCT) programmes must incorporate combination drug treatment for the mother as early in pregnancy as possible.

Asymptomatic bacteriuria (ASB) in pregnant women in Enugu, Nigeria

Background: The main goal of detecting and treating asymptomatic bacteriuria(ASB) in pregnant women is to prevent urinary tract infection(UTI) and its consequences. The value and cost effectiveness of routine screening for ASB in pregnancy is controversial. However, it is agreed that it is worthwhile in populations with high incidence of ASB in pregnancy. Objective: This study aims to evaluate the prevalence, demographic and microbiological characteristics of ASB in pregnancy among booked antenatal patients in Enugu. Study Design, Setting and Subjects: This is a prospective study covering nine months and involving all consenting patients booked at the antenatal clinic of University of Nigeria Teaching Hospital Enugu. Questionnaires were used to collect information from the patients and their urine samples examined. Results: 430 women who had no symptoms of urinary tract infection in pregnancy were screened for ASB. 15.1% of them had ASB in pregnancy. 18.3% of them were in the second trimester. 64.6% of patients with ASB had normal urinalysis Escherichia coli was the commonest pathogen isolated (30.8%). The antibiotic with the highest sensitivity was nitrofurantoin. Conclusion: The prevalence of ASB in our locality is high (15%). We recommend the use of urine culture to routinely screen all pregnant women at their first prenatal visit. Keywords: asymptomatic bacteriuria, pregnancy, urine culture Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 12-13

Factors associated with the use of maternity services in Enugu, southeastern Nigeria

The maternal mortality ratio and other maternal health indicators are worse for developing countries than for the developed world due to improved access to quality care during pregnancy and especially at delivery in the industrialized world. This study was carried out to identify the factors which influenced choice of place of delivery by pregnant women in Enugu, southeastern Nigeria, and to recommend ways to improve women's access to skilled attendants at delivery. A pre-tested questionnaire was administered by interviewers to women who had delivered within 3 months prior to date of data collection. The response rate was 75.5% ( n = 1098 ). Of the respondents, 52.9% delivered outside health institutions and 47.1% in health institutions. The major factors influencing choice of place of delivery included promptness of care, competence of midwife/doctor, affordability, health education, 24 h presence of doctors, team work among doctors and presence of specialist obstetricians. There were statistically significant associations between choice of institutional or non-institutional deliveries and socio-demographic/economic factors such as place of residence (urban/rural), religion, educational status, tribe, marital status, occupational level, husband's occupational and educational levels, age and parity ( p < 0.05 ). We conclude that factors which will positively influence women to deliver in health institutions in Enugu, Nigeria include a variety of interacting social, economic and health system factors, which operate at various levels—the household, community, the health institutions and the larger social and political environment. Attention to these factors will not only improve maternity utilization but, hopefully, also will reduce the high maternal mortality and improve other maternal health indicators in the study area.

Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population

SummaryWe aimed to assess the risk factors for hepatitis B infection among pregnant women in Enugu, southeast Nigeria. This was a prospective case-control study of risk factors for hepatitis B surface antigen positivity among pregnant women seen in two tertiary health institutions in Enugu, southeast Nigeria. It was carried out over an 8-month period, January – August 2005. Of the 1,499 pregnant women attending the antenatal clinic, 4.6% (n = 69) were seropositive for hepatitis B surface antigen. A total of 35 (50.7%) HBsAg positive women and 71 negative controls were interviewed. The risk factors for HBsAg were present in 71% (n = 25) of the positive cases, while only 27% (n = 19) of the negative cases had risk factors. The significant risk factors for HBsAg positivity were higher mean parity, higher number of sexual partners since sexual debut, polygamy and previous positive history of sexually transmitted diseases (STD) (p < 0.05). The two groups did not differ with respect to presence of tattoo or scarification marks, positive history of jaundice or contact with a jaundiced patient, previous blood transfusion or contact with blood products, intravenous drug abuse or sharing personal instruments (p > 0.05). Screening pregnant women for hepatitis B infection on the basis of presence of risk factors may not effective. Universal antenatal screening for HBsAg, health education aimed at reducing risk factors and immunisation of all newborn and those at risk of hepatitis B is advocated.

Influence of formal maternal education on the use of maternityservices in Enugu, Nigeria

SummaryAlthough some previous studies have suggested formal maternal education as the most potent tool for reducing the mortality ratio in Nigeria, other studies found that the depressed Nigerian economy since 1986 has marginalised the benefits of education with the result that educated women stopped making use of existing health facilities because they could not afford the cost of health services. This study was carried out to determine the current influence of formal maternal education and other factors on the choice of place of delivery by pregnant women in Enugu, south-eastern Nigeria. It was a pre-tested interviewer-administered questionnaire study of women who delivered within 3 months before the date of data collection in the study area. In an increasing order of level of care, the outcome variable (place where the last delivery took place) was categorised into seven, with home deliveries representing the lowest category and private hospitals run by specialist obstetricians as the highest category. These were further sub-categorised into non-institutional deliveries and institutional deliveries. Maternal educational level was the main predictor variable. Other predictor variables were sociodemographic factors. Data analysis was by means of descriptive and inferential statistics including means, frequencies and χ2-tests at the 95% confidence (CI) level. Out of a total of 1,450 women to whom the questionnaires were administered, 1,095 women responded (a response rate of 75.5%). A total of 579 (52.9%) of the respondents delivered outside health institutions, while the remaining 516 (47.1%) delivered within health institutions. Regarding the educational levels of the respondents, 301 (27.5%) had no formal education; 410 (37.4%) had primary education; 148 (13.5%) secondary education and 236 (21.5%) post-secondary education. There was a significant positive correlation between the educational levels of the respondents and their husbands (r = 0.86, p = 0.000). With respect to occupational categories of the respondents, 88 (8.0%) of them belonged to occupational class I, 158 (14.4%) to occupational class II, 107 (9.8%) to occupational class III, 14 (1.3%) to occupational class IV and 728 to occupational class V. There was a significant positive correlation between the respondents' and their husbands' occupational levels (r = 0.89, p = 0.000). There were statistically significant associations between choice of institutional or non-institutional deliveries and respondents' educational level as well as place of residence (urban/rural), religion, tribe, marital status, occupational level, husband's occupational and educational levels, age and parity (p ≤ 0.05 for each variable). Further analysis of only the respondents who delivered within health institutions showed that there was a significant positive correlation between their educational levels and the level of care where they delivered (r = 0.45, p = 0.000). Significantly more of them with post-secondary education lived in the urban than in the rural areas, were Christians and were married to husbands of higher educational and economic levels. It is concluded that formal education is still a significant predictor of whether women deliver within or outside health institutions in Enugu, south- eastern Nigeria. Efforts at reducing maternal mortality ratio in Nigeria must increase the adult female literacy rate.