JMIR Publications

ABSTRACT

Background:

Despite substantial progress in maternal health services in Nigeria, a significant proportion of women still deliver without skilled birth attendants, particularly in rural and underserved areas. Maternal mortality remains unacceptably high, often due to preventable causes that could be mitigated through timely access to skilled care during childbirth. Understanding the demographic, socio-economic, and access-related factors influencing the use of skilled delivery services is crucial for designing targeted interventions

Objective:

The primary objective of this study was to investigate the factors influencing the utilization of skilled birth attendants among women in Nigeria. Specifically, the study aimed to assess the impact of age, marital status, religion, education, occupation, place of residence, geographical region, and transportation means on skilled delivery service use.

Methods:

The study utilized data from the Nigeria Demographic and Health Survey (NDHS), applying a cross-sectional design. Descriptive statistics, chi-square tests, and logistic regression analyses were used to examine associations and determine adjusted odds ratios (ORs) with 95% confidence intervals (CI). Data were visualized using bar and column charts for clarity. Variables were categorized and analyzed to compare skilled versus unskilled delivery usage across different subgroups.

Results:

The results revealed that education, urban residence, employment, and use of motorized transport were strong predictors of skilled birth attendance. Women with post-secondary education had the highest odds of utilizing skilled delivery services (OR=5.39). Urban dwellers and employed women were significantly more likely to access skilled care, while rural residents and those without formal education lagged behind. Religion and region also played substantial roles; Christian women and those from the South had markedly higher utilization rates compared to their northern and Muslim counterparts. Means of transportation emerged as a critical enabler, with women using vehicles or bikes having over 10 times higher odds of skilled delivery compared to pedestrians.

Conclusions:

The findings underscore the influence of socio-demographic and infrastructural factors on maternal healthcare utilization. Disparities in skilled birth attendance are significantly shaped by education, region, religion, and access to transport. Addressing these inequalities is essential to improve maternal outcomes and reduce preventable mortality. To improve skilled delivery uptake: Enhance girl-child education and women's empowerment; Strengthen rural health infrastructure and transportation systems; Promote awareness through culturally tailored health communication; Develop region-specific interventions targeting vulnerable groups and Foster public-private partnerships to subsidize maternity services. Improving access to skilled delivery services can drastically reduce maternal and neonatal deaths in Nigeria. Policies that bridge gaps in education, infrastructure, and socio-economic inequities are essential for ensuring every woman has the opportunity for a safe and dignified childbirth experience.