Determinants of choice of orthodox and informal maternity facilities among women in an urban community in Ibadan, Southwest Nigeria.

Abstract

Background: Utilization of Antenatal Care (ANC) and skilled assistance during delivery are required to reduce maternal mortality and morbidity. Lack of skilled care during pregnancy and delivery is associated with poor pregnancy and delivery outcomes. The facility chosen for antenatal care and delivery determines whether women receive care from skilled or unskilled personnel. More ^information is needed on facility preferences of Nigerian women for ANC. This study was therefore conducted to assess antenatal care utilization, choice of facility for antenatal care and delivery among women in an urban community in Ibadan, Nigeria. Methods: This was a cross-sectional study. A two-stage cluster sampling technique was used to select 351 women in Yemetu area. A pretested semistructured questionnaire was used to obtain information on socio-demographic characteristics, antenatal care component, facility chosen for antenatal care and delivery, as well as the reasons for utilizing these facilities. Private and governmentowned health facilities were classified as orthodox facilities while mission homes and facilities run by traditional birth attendants were classified as informal facilities. Results: The mean age of respondents was 28.8 ± 5.6 years. 81.5% had at least secondary education. Sixty-two (17.7%) of respondents chose informal facilities for antenatal care and 76 (21.7%) delivered in informal facilities. Good component of antenatal care was received by 93.8% of women in orthodox facilities compared to 74.2% in informal facilities (p= 0.001). Respondents' educational attainment was the single predictor of choice of informal facilities for antenatal care (OR=2.6; 95%CI= 1.4 - 4.9). The predictors of the choice of informal facilities for delivery were respondents who did not have antenatal care with skilled personnel at least once (OR=252.4; 95%CI= 78.2 — 817.9), and those who did not have someone to take them to the hospital during labor (OR=4.38; 95%CI= 1.6-12.3). Conclusion: There is a need to promote utilization of orthodox facilities for antenatal care especially among women of lower educational status.