Patterns of utilization and determinants of maternal health services among women residing in low-income communities in Lagos State, Nigeria.

IF 2.5
PLOS global public health Pub Date : 2025-09-24 eCollection Date: 2025-01-01 DOI:10.1371/journal.pgph.0004862
Tope Olubodun, Onikepe Owolabi, Oluseun Adejugbe, Olufunke Iroko, Chiamaka Uwalaka, Bosede Afolabi
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Abstract

Maternal and perinatal morbidity and mortality can be significantly prevented when women utilize health facilities for antenatal care (ANC), delivery and postnatal care; particularly in low-income communities in sub-Saharan Africa, where facility-based maternal care is underutilized. This study assessed the pattern of utilization and determinants of uptake of maternal health services among women residing in low-income communities in Lagos State, Nigeria. This was a mixed methods cross-sectional study, among women of reproductive age 15 - 49 years. Quantitative data was collected from 3,651 women using interviewer-administered questionnaires. Twenty Focus Group Discussions were carried out among 172 women. Univariate, bivariate and multinomial regression was done to identify determinants of place of delivery.The mean age of respondents was 32 ± 6.4 years. Almost all the women (97.7%) had ANC during their last pregnancy regardless of provider. During ANC visits, 56.4% were attended to by a nurse/midwife, 24.2% by a doctor and 19.4% by a traditional birth attendant (TBA). Thirty-nine per cent of respondents had their last child delivered in a public health facility, 30.8% in a private health facility, and 30.2% at a TBA/religious centre/home. Determinants of facility delivery utilization include higher levels of education, higher household incomes, middle and rich wealth index, fewer number of children and higher level of satisfaction with healthcare facilities.. Reasons for choice of place of ANC and delivery from the qualitative inquiry included distance from homes, attitude of health workers and quality of care, affordability, choice of spouse, and belief in herbs/spiritual beliefs.A significant proportion of women delivered with TBA/religious centre/at home. To improve use of health facilities for maternal care, efforts must be steered at improving health worker attitudes, addressing geographical accessibility and affordability, promoting health insurance, and carrying along all relevant stakeholders including spouses, and religious and traditional leaders.

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尼日利亚拉各斯州低收入社区妇女利用孕产妇保健服务的模式和决定因素。
当妇女利用保健设施进行产前护理、分娩和产后护理时,产妇和围产期发病率和死亡率可得到显著预防;特别是在撒哈拉以南非洲的低收入社区,在那里,以设施为基础的孕产妇保健没有得到充分利用。这项研究评估了居住在尼日利亚拉各斯州低收入社区的妇女利用孕产妇保健服务的模式和决定因素。这是一项混合方法的横断面研究,研究对象为15 - 49岁的育龄妇女。通过访谈者填写的问卷,从3651名女性中收集了定量数据。在172名妇女中进行了20次焦点小组讨论。采用单变量、双变量和多项回归来确定交货地点的决定因素。受访者平均年龄32±6.4岁。几乎所有妇女(97.7%)在最后一次怀孕期间都有ANC,无论提供者是谁。在非国大访问期间,56.4%由护士/助产士护理,24.2%由医生护理,19.4%由传统助产士(TBA)护理。39%的答复者在公共卫生机构分娩最后一个孩子,30.8%在私人卫生机构分娩,30.2%在TBA/宗教中心/家庭分娩。设施提供利用率的决定因素包括较高的教育水平、较高的家庭收入、中等和富裕的财富指数、较少的儿童数量和较高的医疗保健设施满意度。从定性调查中选择分娩地点和分娩的原因包括离家的距离、卫生工作者的态度和护理质量、负担能力、配偶的选择以及对草药/精神信仰的信仰。相当比例的妇女在TBA/宗教中心/家中分娩。为了改善卫生设施对孕产妇保健的利用,必须努力改善卫生工作者的态度,解决地理可及性和可负担性问题,促进健康保险,并让包括配偶、宗教和传统领导人在内的所有相关利益攸关方参与进来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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