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When Women Deliver with No One Present in Nigeria: Who, What, Where and So What?

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  • Bolaji M Fapohunda
  • Nosakhare G Orobaton

Abstract

With the current maternal mortality ratio (MMR) of 630/100,000 live births, Nigeria ranks among the nations with the highest mortality rates in the world. The use of skilled assistants during delivery has been identified a key predictor in the reduction of mortality rates in the world over. Not only are Nigerian women predominantly using unskilled attendants, one in five births are delivered with No One Present (NOP). We assessed who, what, where and the so what of this practice using 2008 Nigeria DHS (NDHS) data. The study revealed that the prevalence of NOP is highest in the northern part of Nigeria with 94% of all observed cases. Socio-demographic factors, including, women’s age at birth, birth order, being Muslim, and region of residence, were positively associated with NOP deliveries. Mother’s education, higher wealth quintiles, urban residence, decision-making autonomy, and a supportive environment for women’s social and economic security were inversely associated with NOP deliveries. Women’s autonomy and social standing were critical to choosing to deliver with skilled attendance, which were further amplified by economic prosperity. Women’s’ economic wellbeing is entwined with their feelings of independence and freedom. Programs that seek to improve the autonomy of women and their strategic participation in sound health seeking decisions will, most likely, yield better results with improvements in women’s education, income, jobs, and property ownership. As a short term measure, the use of conditional cash transfer, proven to work in several countries, including 18 in sub-Saharan Africa, is recommended. Its use has the potential to reduce household budget constraint by lowering cost-related barriers associated with women’s ability to demand and use life-saving services. Given the preponderance of NOP in the Northern region, the study suggests that interventions to eradicate NOP deliveries must initially focus this region as priority.

Suggested Citation

  • Bolaji M Fapohunda & Nosakhare G Orobaton, 2013. "When Women Deliver with No One Present in Nigeria: Who, What, Where and So What?," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-12, July.
    • Handle: RePEc:plo:pone00:0069569
    DOI: 10.1371/journal.pone.0069569
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    References listed on IDEAS

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    1. Prata, Ndola & Ejembi, Clara & Fraser, Ashley & Shittu, Oladapo & Minkler, Meredith, 2012. "Community mobilization to reduce postpartum hemorrhage in home births in northern Nigeria," Social Science & Medicine, Elsevier, vol. 74(8), pages 1288-1296.
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    Cited by:

    1. Bola Lukman Solanke, 2021. "Do the determinants of institutional delivery among childbearing women differ by health insurance enrolment? Findings from a population‐based study in Nigeria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 668-688, May.
    2. Pratley, Pierre, 2016. "Associations between quantitative measures of women's empowerment and access to care and health status for mothers and their children: A systematic review of evidence from the developing world," Social Science & Medicine, Elsevier, vol. 169(C), pages 119-131.
    3. Robin A. Richardson, 2018. "Measuring Women’s Empowerment: A Critical Review of Current Practices and Recommendations for Researchers," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 137(2), pages 539-557, June.
    4. Sanni Yaya & Ghose Bishwajit & Olalekan A Uthman & Agbessi Amouzou, 2018. "Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-11, May.

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