Maternal Death Self-Risk Perception as a Predictor of Women’s Delivery Site Preferences in Ile-Ife, Nigeria

Authors

  • Oluwaseun Esan Department of Community Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University/Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Uchechi Grace Okonta Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
  • Oluwaseun Samuel Oladapo Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
  • Adetomiwa Phillip Gbolade Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
  • Tesleem Adebayo Oyewole Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria

DOI:

https://doi.org/10.26911/thejmch.2024.09.04.03

Abstract

Background: Increased uptake of health facility delivery could improve the worsening maternal mortality in low and middle-income countries. Several factors that determine women’s preferred delivery site had been reported in the literature, but none had explored women’s self-perception of maternal death as a predictor of their delivery site, hence this study.

Subjects and Method: A cross-sectional study of 183 women recruited serially at the immuni­za­tion clinic of two primary health facilities in Ile-Ife, Nigeria. Data was obtained using an interviewer-administered questionnaire. Their maternal death self-risk perception score by type of delivery site was determined with a minimum and maximum obtainable score of 7 and 35. Descriptive and inferential statistical analysis was done including a simple and multiple binary logistic regression.

Results: The mean age of the respondents (Mean= 29; SD= 5.26).  About 130 (71.0%) of the women delivered at a health facility. The majority of the women (91.8%) were aware of maternal death, while 32 (17.5%) feared death in their last pregnancy, with a mean maternal death self-risk perception score ((Mean= 24.96; SD= 2.69) (95% CI= 24.55 to 25.33)). The higher the maternal death self-risk perception score, the greater the odds of a facility-based delivery (AOR=1.40, 95% CI=1.20 to 1.64, p<0.001). However, alongside other confounding variables, only a facility-based ANC registration (AOR= 607.52, 95% CI= 1.39 to 2.66*105, p=0.039) and women’s personal reasons (AOR=0.02; 95%CI= 0.01 to 0.51; p=0.018) significantly influenced delivering at a health facility and non-health facility respectively.  

Conclusion: The place of ANC registration and personal reasons such as the women’s influential decision-makers better predicted their eventual delivery site. Nonetheless, the development and standardization of maternal death self-risk perception criteria for women is encouraged.

Keywords:

Delivery site, Childbirth, maternal health, risk perception, maternal death

References

Ajayi AI, Akpan W (2020). Maternal health care services utilisation in the context of 'Abiye' (safe motherhood) programme in Ondo State, Nigeria. BMC Public Health. 20(1):362. doi: 10.1186/s1288902008512z.

Al-Hindi MY, Al Sayari TA, Al Solami R, Al Baiti AK, Alnemri JA, Mirza IM, Alattas A, Faden YA (2020). Association of antenatal risk score with maternal and neonatal mortality and morbidity. cureus. 12(12):e12230. doi: 10.7759/cureus.12230.

Al-Mujtaba M, Cornelius LJ, Galadanci H, Erekaha S, Okundaye JN, Adeyemi OA, Sam-Agudu NA (2016). Evaluating Religious influences on the utilization of maternal health services among muslim and christian women in North-Central Nigeria. Biomed Res Int. 2016:3645415. doi: 10.1155/2016/3645415.

Alemu DA, Zegeye AM, Zeleke LB, Dessie WK, Melese YD, Tarik YD, Zeleke FT, et al. (2022). Pregnancy risk perception and associated factors among pregnant women attending antenatal care at health centers in Jabi Tehnan District, Amhara, North-western Ethiopia, 2021. Int J Reprod Med. 2022:6847867. doi: 10.1155/2022/6847867.

Ali MH, Seif SA, Kibusi SM (2022). The influence of fear during pregnancy, labour and delivery on birth outcome among post-delivery women: a case control study in Zanzibar. East Afr Health Res J. 6(2):147-154. doi: 10.24248/eahrj.v6i2.693.

Aoyama K, D'Souza R, Pinto R, Ray JG, Hill A, Scales DC, Lapinsky SE, Seaward GR, et al. (2018). Risk prediction models for maternal mortality: A systematic review and meta-analysis. PLoS One. 13(12):e0208563. doi: 10.1371/journal.pone.0208563.

Boah M, Mahama AB, Ayamga EA (2018). They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana. BMC Pregnancy Childbirth. 18(1):125. doi: 10.1186/s1288401817496.

Bohren MA, Hunter EC, Munthe-Kaas HM, et al. (2014). Facilitators and barriers to facility-based delivery in low-and middle-income countries: a qualitative evidence synthesis. Reprod Health 11, 71 (2014). https://doi.org/10.1186/174247551171

Bola R, Ujoh F, Ukah UV, Lett R (2022). Assessment and validation of the Community Maternal Danger Score algorithm. Glob Health Res Policy. 7(1):6. doi: 10.1186/s41256022002408.

Chinkhumba J, De Allegri M, Muula AS, Robberstad B (2014). Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: a meta-analysis of population-based cohort studies. BMC Public Health. 14:1014. doi: 10.1186/14712458141014.

Dahiru T, Oche OM (2015). Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria. Pan Afr Med J. 21:321. doi: 10.11604/pamj.2015.21.321.6527.

Dauda R (2023) Maternal mortality in nigeria: what is known and what needs to be done, The Nigerian Economic Summit Group. Available at: https://nesgroup.org/download_resource_documents/NRFP Policy Brief-Prof RisikatDauda(MM)_1701236063.pdf (Accessed: 3 April 2024).

Ewokor C (2016). Nigeria campaign to stop women giving birth in church, BBC Africa. Available at: https://www.bbc.com/news/world-africa35942603 (Accessed: 5 April 2024).

Fabusiwa OF, Adejugbagbe AM, Akinboboye O (2016). Preference for church-based maternity centers among women seeking delivery services in akoko south west local government area of ondo state, Nigeria’, International Journal of Sciences, 5(03): 1–8. doi: 10.18483/ijsci.943.

Girum T, Wasie A (2017). Correlates of maternal mortality in developing countries: an ecological study in 82 countries. Matern Health Neonatol Perinatol. 2017 Nov 7;3:19. doi: 10.1186/s4074801700598.

Graham WJ, Bell JS, Bullough CHW (2001). Can skilled attendance at delivery reduce maternal mortality in developing countries?. Studies in HSO&P, 17: 97–129. Available at: http://193.190.239.98/bitstream/handle/10390/2655/2001shsop0097.pdf?sequence=2 (Accessed: 10 September 2015).

Gunawardena N, Bishwajit G, Yaya S (2018). Facility-Based Maternal Death in Western Africa: A Systematic Review. Front Public Health. 6:48. doi: 10.3389/fpubh.2018.00048.

Hashemi A, Oroojan AA, Rassouli M, Ashrafizadeh H (2023). Explanation of near-death experiences: a systematic analysis of case reports and qualitative research. Front Psychol. 4:1048929. doi: 10.3389/fpsyg.2023.1048929.

Johnson OE, Obidike PC, Eroh MU, Okpon AA, Bassey EI, Patrick PC, Ebong PE, Ojumah E (2020). Choices and determinants of delivery location among mothers attending a primary health facility in Southern Nigeria. Niger Postgrad Med J. 27(1):42-48. doi: 10.4103/npmj.npmj_150_19.

Munyaradzi Kenneth D, Marvellous M, Stanzia M, Memory DM (2016). Praying until death: apostolicism, delays and maternal mortality in Zimbabwe. PLoS One. 11(8): e0160170. doi: 10.1371/journal.pone.0160170.

Mayekiso ND, Ter Goon D, Vellem N, Okafor UB, Rala NM (2020). Perceptions of women of reproductive age towards maternal death in Qaukeni sub-District, Eastern Cape Province, South Africa: A qualitative study. Afr J Reprod Health. 24(4):147-163. doi: 10.29063/ajrh2020/v24i4.16.

Mekie M, Taklual W (2019). Delivery place preference and its associated factors among women who deliver in the last 12 months in Simada district of Amhara Region, Northwest Ethiopia: a community based cross sectional study. BMC Res Notes. 12(1):114. doi: 10.1186/s1310401941587.

Moyer CA, Mustafa A (2013). Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod Health 10, 40 (2013). https://doi.org/10.1186/174247551040

National Population Commission (NPC) Nigeria and ICF (2019). Nigeria Demographic and Health Survey 2018, Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF: NPC and ICF. Available at: https://dhsprogram.com/pubs/pdf/FR359/FR359.pdf (Accessed: 17 July 2019).

Olivier J, Tsimpo C, Gemignani R, Shojo M, Coulombe H, Dimmock F, Nguyen MC, et al. (2015). Understanding the roles of faith-based healthcare providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction. Lancet. 386(10005):1765-75. doi: 10.1016/S01406736(15)602513.

Olonade O, Olawande TI, Alabi OJ, Imhonopi D (2019). Maternal mortality and maternal health care in nigeria: implications for socio-economic deve-lopment. Open Access Maced J Med Sci. 7(5): 849–855. doi: 10.3889/oamjms.2019.041.

Roro MA, Hassen EM, Lemma AM, Gebreyesus SH, Afework MF (2014). Why do women not deliver in health facilities: a qualitative study of the community perspectives in south central Ethiopia? BMC Res Notes. 7:556. doi: 10.1186/175605007556.

Sadore AA, Kebede Y, Birhanu Z (2023). Pregnancy Risk perception, knowledge of obstetric danger signs and attitude towards skilled delivery service utilization among pregnant mothers in a rural setting in South Ethiopia: A Community-Based Cross-Sectional Study. Int J Womens Health. 15:18451856. doi: 10.2147/IJWH.S432447.

Udo IE, Doctor HV (2016). Trends in health facility births in sub-Saharan Africa: an analysis of lessons learned under the millennium development goal framework. Afr J Reprod Health. 220(3):108-117. doi: 10.29063/ajrh2016/v20i3.15.

Udoma EJ, Ekanem AD, Abasiattai AM, Bassey EA (2008). Reasons for preference of delivery in spiritual church-based clinics by women of south-south Nigeria. Niger J Clin Pract. 11(2):1003.

United Nations Children’s Fund (2020). Global Delivery Care Coverage and Trends: Percentage of births assisted by a skilled birth attendant by country, 2014-2019, UNICEF Data. Available at: https://data.unicef.org/topic/maternal-health/delivery-care/ (Accessed: 12 May 2020).

World Health Organization (2018) Definition of skilled health personnel providing care during childbirth: the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA, Reproductive Health. Geneva, Switzerland. Available at: https://www.who.int/reproductivehealth/defining-competent-mnh-professionals/en/ (Accessed: 12 May 2020).

World Health Organization (2019a) Maternal health in Nigeria: generating information for action, Human Reproduction Program: Research for Impact. Geneva, Switzerland. Available at: https://www.who.int/reproductivehealth/maternal-health-nigeria/en/ (Accessed: 12 May 2020).

World Health Organization (2019b) Maternal Mortality, Factsheet. Geneva, Switzerland. Available at: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality (Accessed: 11 May 2020).

World Health Organization (2020) Skilled Birth Attendants, Human Reproduction Program: Research for Impact. Available at: https://www.who.int/reproductivehealth/topics/mdgs/skilled_birth_attendant/en/ (Accessed: 12 May 2020).

World Health Organization (2023) Proportion of births attended by skilled health personnel (%), Data: Indicators. Available at: https://data.who.int/indicators/i/1772666 (Accessed: 3 April 2024).

World Health Organization (2023). Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/-Population Division, Sexual and Reproductive Health and Research Team. Geneva, Switzerland. Available at: https://www.who.int/reproductivehealth/publications/maternal-mortality-2000-2017/en/.

World Health Organization (2021). World Health Organization strategy for engaging religious leaders, faith-based organizations and faith communities in health emergencies, World Health Organization. Available at: https://www.who.int/publications/i/item/9789240037205 (Accessed: 10 April 2024).

Xu Y, Peng MYP, Ahuru RR (2022) ‘Individual and community-level factors associated with non-institutional delivery of women of childbearing age in Nigeria’, Humanities and Social Sciences Communications. Springer US, 9(1): 5–11. doi: 10.1057/s41599022011687.

Yakoob MY, Ali MA, Ali MU, Imdad A, Lawn JE, Van Den Broek N, Bhutta ZA (2011). The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths. BMC Public Health. 11 Suppl 3(Suppl 3):S7. doi:10.1186/1471245811S3S7.

Yaya S, Bishwajit G, Uthman OA, Amouzou A. (2018). Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria. PLoS One. 13(5):e0196896. doi: 10.1371/journal.pone.0196896.

Downloads

Published

2024-07-16

How to Cite

Esan, O., Grace Okonta, U., Samuel Oladapo, O., Phillip Gbolade, A., & Adebayo Oyewole, T. (2024). Maternal Death Self-Risk Perception as a Predictor of Women’s Delivery Site Preferences in Ile-Ife, Nigeria. Journal of Maternal and Child Health, 9(4), 462–660. https://doi.org/10.26911/thejmch.2024.09.04.03

Issue

Section

Articles