Abstract:

Background: Health facility delivery is an important factor in reducing deaths arising from complications of pregnancy. Despite the importance of prenatal care the extent of its contribution to hospital based delivery has not yet been evaluated in Nigeria. This study aimed to estimate the extent of the contribution of pre-natal care to hospital delivery in Nigeria.

Methods: Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were utilized. The 2013 NDHS was conducted in all the states of Nigeria including the Federal Capital Territory (FCT). The study population comprised of 31 ,828 women of reproductive age (15-49 years) who were asked questions from the delivery module. The primary data for the survey were collected by visiting households and conducting face-to-face interviews and with the use of questionnaires to obtain information. Data was analysed using SPSS version 21 .

Result: The mean age of mother was 29.4 years ± 7 standard deviation. The prevalence of health facility based delivery in 2013 was 35.8% . Prenatal care was received by 13477(66%). Among Nigeria women 34.6% felt delivering their babies in the hospital was not important. Among those who received pre-natal care 7350(54.6%) delivered in the health facilities compared to 289(4.2%) health facility delivery among those who did not receive pre-natal care. (p<0.001). Those who received pre-natal care were 12 times more likely to deliver in the health facility (95% CI= 10.56-14.42) p<0.001 . In those who had prenatal care 53% reduction in home delivery occurred.

Conclusion: To increase health facility delivery in Nigeria efforts to encourage the use of antenatal care services are pertinent.

References:

[1.] Abebe, F., Berhane, Y. & Girma, B. (2012) Factors associated with home delivery in Bahirdar, Ethiopia: A case control study. BMC Res Notes, 5.

[2.] Ahmed, S., Creanga, A., Gillespie, D. & Tsui, A. (2010) Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS ONE [Electronic Resource], 5.

[3.] Doctor, H. (2011) Intergenerational differences in antenatal care and supervised deliveries in Nigeria. Health Place, 17, 480‐489.

[4.] Emelumadu, O., Onyeonoro, U., Ukegbu, A., Ezeama, N., Ifeadike, C. & Okezie, O. K. (2014) Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria. Niger Med J, 55, 148‐155.

[5.] Faye, A., Niane, M. & Ba, I. (2011) Home birth in women who have given birth at least once in a health facility: contributory factors in a developing country. Acta Obstet Gynecol Scand, 90, 1239‐43.

[6.] Federal Republic of Nigeria (2008) Mid ‐Point Assessment of the Millennium Development Goals in Nigeria 2000 ‐2007. Abuja: The Office of the Senior Special Assistant to the President on the MDGs.

[7.] Franny, A. (2013) Gulu women’s economic development and globalization http://www.globalgiving.org/pfil/9326/Quaterly_Report_April__June_2013.pdf.

[8.] Gabrysch, S., Cousens, S., Cox, J. & Campbell, O. (2011) The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS Medicine, 8.

[9.] Galaa, S. & Daare, K. (2008) Understanding barriers to maternal child health services utilization in northern Ghana. Journal of Social Development in Africa, 23, 127‐155.

[10.] Harvey, S., Blandon, Y., McCaw‐Binns, A., Sandino, I., Urbina, L. & Rodriguez, C., et al. (2007) Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward. Bull World Health Organ, 85, 783‐790.

[11.] Idris, S., Gwarzo, U. & Shehu, A. (2006) Determinants of place of delivery among women in a semiurban settlement in Zaria, northern Nigeria. Ann Afr Med., 5, 68‐72.

[12.] Idris, S., Sambo, M. & Ibrahim, M. (2013) Barriers to utilisation of maternal health services in a semiurban community in northern Nigeria: the clients’ perspective. Nigerian Medical Journal, 54, 27‐32.

[13.] Ilesanmi, O., Ige, O. & Adebayo, A. (2013) The Role of Antenatal Care in Pregnancy Outcome: A Comparative Study in South Western Nigeria Article from the 13th world congress on Public Health April 23‐27, 2012‐Addis Ababa (Ethiopia). Medimond International Proceedings, 23‐ 26.

[14.] Khalid, S., Daniel, W. & Lale, S. (2006) WHO analysis of causes of maternal death: a systemic review. The Lancet Maternal Survival Series, 367, 1066‐1074.

[15.] Lawn, J., Cousens, S. & Zupan, J. (2005) Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet, 365, 891‐900.

[16.] Lozano, R., Wang, H., Foreman, K., Rajaratnam, J., Naghavi, M. & Marcus, J., et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet, 378, 1139‐1165.

[17.] Mengesha, Z., Biks, G., Ayele, T., Tessema, G. & Koye, D. (2013) Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study. BMC Public Health, 13.

[18.] Montagu, D., Yamey, G., Visconti, A., Harding, A. & Yoong, J. (2011) Where do poor women in developing countries give birth? A multi‐country analysis of demographic and health survey data. PLoS One, 6.

[19.] Moore, B., Alex‐Hart, B. & George, I. (2011) Utilization of health care services by pregnant mothers during delivery: a community based study in Nigeria. East Afr J Public Health, 8, 49‐51.

[20.] Mpembeni, R., Killewo, J., Leshabari, M., Massawe, S., Jahn, A., Mushi, D. & Mwakipa, H. (2007) Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG‐5 targets. BMC Pregnancy Childbirth, 7.

[21.] National Population Commission (NPC) [Nigeria] & Macro, I. C. F. (eds.) 2009. Nigeria Demographic and Health Survey 2008, Abuja, Nigeria: National Population Commission and ICF Macro.

[22.] National Population Commission (NPC) [Nigeria] and ICF International (2014) Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.

[23.] Osubor, K., Fatusi, A. & Chiwuzie, J. (2006) Maternal health‐seeking behavior and associated factors in a rural Nigerian community. Matern Child Health J, 10, 159‐6.

[24.] Rajaratnam, J., Marcus, J., Flaxman, A., Wang, H., Levin‐Rector, A. & Dwyer, L., et al. (2010) Neonatal, post‐neonatal, childhood, and under‐5 mortality for 187 countries, 1970‐2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet, 375, 1988‐ 2000.

[25.] Rockers, P., Wilson, M., Mbaruku, G. & Kruk, M. (2009) Source of antenatal care influences facility delivery in rural Tanzania: a population‐based study. Matern Child Health J 13, 879‐85.

[26.] Stephenson, R., Baschieri, A., Clements, S., Hennink, M. & Madise, N. (2006) Contextual influences on the use of health facilities for childbirth in Africa. Am J Pub Health, 96, 84‐93.

[27.] United Nations Population Fund. 2015. Sub‐Saharan Africa’s maternal death rate down 41 percent. 201 http://africa.unfpa.org/public/cache/offence/news/pid/10767. Accessed 05 May 2015. [Online].

[28.] Wang, W., Alva, S., Wang, S. & Fort, A. (2011) Levels and Trends in the Use of Maternal Health Services in Developing Countries. DHS Comparative Reports No. 26. Calverton, Maryland: ICF Macro.

[29.] Woldemicael, G. (2010) Do women with higher autonomy seek more maternal health care? Evidence from Eritrea and Ethiopia. Health Care Women Int 31, 599‐620.

[30.] Yanagisawa, S., Oum, S. & Wakai, S. (2006) Determinants of skilled birth attendance in rural Cambodia. Trop Med Int Health, 11, 238‐251.