Antenatal Care Utilization and Delivery Location: Evidence from Postpartum Women in Enugu, South East Nigeria.

Abstract

Background and objective: Maternal mortality is high in sub-Saharan African countries. This death can be prevented by increasing the percentage of deliveries attended by skilled birth attendants (SBA). In Nigeria, most women still deliver with traditional birth attendants (TBA), leading to complications and death. This study examined factors associated with antenatal care (ANC) and delivery location among recently delivered women attending an immunization clinic in Enugu, Nigeria.

Methods: This was a cross-sectional survey involving 501 participants. A pretested questionnaire was used to collect data through purposive sampling. Independent variables included the socio-demographic characteristics. The dependent variable was the choice of delivery location. Demographic characteristics and descriptive statistics were reported as percentages and frequencies. Associations between the variables were analyzed using chi-square testing. A two-sided p value below 0.05 was considered statistically significant.

Results: Most participants attended ANC (92.8%) and delivered (90.6%) in a healthcare facility with SBA. The most common person influencing the choice of delivery location was "self" (54.8%). The most considered factor in choosing a place of delivery was the competence of the doctor/midwife (85.9%). Significant associations were found between choice of place of delivery and age (ꭓ ² = 11.403; p = 0.010), educational status (ꭓ ² = 61.012; p = 0.001), occupation (ꭓ ² = 14.931; p = 0.002), and monthly income (ꭓ ² = 44.440; p < 0.001).

Conclusion and global health implications: Most women received ANC and gave birth in a healthcare facility, though a few used home, spiritual houses, and TBAs. The choice of care location is associated with personal, socio-demographic, economic, and hospital-related factors. The findings suggest that perceived staff competence and service availability may influence women's decisions about where to seek maternity care.