BMJ Open: Home childbirth among young mothers aged 15-24 years in Nigeria

7 October, 2019

This new paper in BMJ Open find a very high prevalence of home births among youn mothers in Nigeria, especially in rural areas. One of the findings is: 'Young mothers who listened to radio services for less than once a week had 46% increased odds of home delivery compared with those who listened at least once in a week... The benefits of this finding need to be well explored by appropriately using radio services in behaviour change communication/health promotion targeted at adolescents and young mothers in Nigeria.'

CITATION: BMJ Open. 2019 Sep 18;9(9):e025494. doi: 10.1136/bmjopen-2018-025494.

Home childbirth among young mothers aged 15-24 years in Nigeria: a national population-based cross-sectional study.

Adewuyi EO1,2, Khanal V3, Zhao Y4, David L5, Bamidele OD6, Auta A7.

Abstract

OBJECTIVE: To estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15-24 years in Nigeria.

DESIGN: A secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS).

SETTING: Nigeria.

PARTICIPANTS: A total of 7543 young mothers aged 15-24 years.

OUTCOME MEASURE: Place of delivery.

RESULTS: The prevalence of home delivery among young mothers aged 15-24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria - 78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p<0.001) in urban Nigeria. Using the Andersen's behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and <4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors-lack of maternal and husband's education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio-were associated with increased odds of home delivery.

CONCLUSIONS: Young mothers aged 15-24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria.

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org