ABSTRACT
Due to better access to excellent treatment during pregnancy and especially at delivery in the industrialized world, the maternal death ratio and other maternal health indices are worse in underdeveloped nations than in the developed world. This study was conducted to determine the factors that influenced pregnant women’s choice of delivery location in Enugu, southeastern Nigeria, and to make recommendations for improving women’s access to professional attendants during delivery. Interviewers gave a pre-tested questionnaire to mothers who had given birth within three months of the data collection date. The response rate (n=1098) was 75.5 percent. 52.9 percent of respondents delivered outside of health institutions, whereas 47.1 percent delivered in health institutions. Promptness of care, midwife/doctor competency, affordability, health education, 24 hour presence of doctors, teamwork among doctors, and presence of specialized obstetricians were all important criteria in deciding where to birth. There were statistically significant relationships between location of residence (urban/rural), religion, educational status, tribe, marital status, occupational level, husband’s occupational and educational levels, age, and parity (p0.05). We suggest that a variety of interacting social, economic, and health system elements, which work at several levels—the home, community, health institutions, and the larger social and political environment—will positively impact women to deliver at health institutions in Enugu, Nigeria. Paying attention to these characteristics would not only increase maternity usage, but will also, hopefully, lower maternal mortality and improve other maternal health indicators in the research area.
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