Determinants of Childbearing Age Women's Reliance on Skilled Birth in Benin: Secondary Data Analysis Based on the Fifth Demographic and Health SurveyA

Recourse to skilled birth attendance is known for contributing to a better outcome of pregnancy and childbirth. The purpose of this study was to examine the determinants of skilled birth attendance in Benin. This was a cross-sectional study that involved performing a secondary analysis using data from the fifth Demographic and Health Survey. The study population was women of childbearing age successfully surveyed, usually residing in the households visited, and having had at least one live birth in the five years preceding the survey. The dependent variable was the assistance of a skilled attendant for the last delivery (Yes vs. No). Woman, household, and environmental characteristics were also entered. Multivariate logistic regression was performed to identify the factors that determine births attended by skilled professionals. Overall, 8,816 women were included in the study. Of the women surveyed, 79.39% (95% CI = 77.25-81.38) had delivered with the assistance of a skilled attendant at the end of their last pregnancy. Women aged 30-39 years (aOR = 1.33; 95% CI = 1.09-1.62), with secondary education and above (aOR = 1.34; 95% CI = 1.03-1.75), single (aOR = 1.35; 95% CI = 1.02-1.78), Christian (aOR = 1.97; 95% CI = 1.50-2.58), and professionally active (aOR = 1.27; 95% CI = 1.00-1.60) were more likely to give birth assisted by skilled attendants than, respectively, women aged 40-49 years, with no formal education, in couples, with no religion, and with no work activity, respectively. Similarly, primiparous women (aOR = 1.35; 95% CI = 1.04-1.74) and those who observed antenatal consultations (aOR = 1.83, 95% CI = 1.50-2.23) were more likely to have skilled attendants at delivery than multiparous women and those who did not observe antenatal consultations, respectively. The odds of delivering with skilled attendance were significantly higher for women living in households of 1-5 persons (aOR = 1.22; 95% CI = 1.03-1.44) and wealthy (aOR = 4.79; 95% CI = 2.93-7.85) compared to women living in households of more than five persons and poor, respectively. In addition, disparities related to county of residence were observed. Interventions targeting older women, strengthening education, information and communication, antenatal consultation compliance, women's economic empowerment, and poverty reduction, including addressing geographic disparities, are needed to increase the use of skilled birth attendance by pregnant women.