Keywords
institutional delivery
maternal health
Abstract
Introduction: Skilled antenatal care (ANC) coverage
has increased in low-and middle-income countries
(LMICs) recently, however, maternal and child
mortality rates remain high due to low institutional
delivery rates.
Methods: This was a cross-sectional survey
conducted in a peri-urban setting using multi-stage
sampling technique to select wards, communities and
respondents for the study. A total of 617 mothers of
under-5 children were interviewed for the study.
Results: The mean age of respondents was
29.5(±6.5) years, about half were Christians (52.9%)
and urban residents (51.5%). More than half (56.9%)
had secondary education and majority (74.1%) were
self-employed. Most respondents (94.6%) attended
ANC during their last pregnancy but less than half
(47.8%) completed 4 visits or more. Almost half
(49%) preferred primary health facilities for ANC
but 37.4% delivered in hospitals. The choice of ANC
and delivery providers was significantly associated
with age, education, employment status and place of
residence. There was a significant association
between gestational age at commencement of ANC
and switching to a higher level facility for delivery
(positive shift) while maternal age showed non
statistically significant association with negative shift.
Conclusion: Due to poor retention of ANC attendees
for delivery in PHCs, many pregnant women drop
out of the care continuum by delivering without the
assistance of skilled birth attendants, constituting a
missed opportunity to reduce maternal/newborn
mortality through institutional delivery. We
recommend interventions such as sensitization of
pregnant women on the benefits of delivery in health
facilities, subsidizing maternal care services at PHCs,
and the provision of maternal care services that will
improve pregnancy and birth outcomes to improve
institutional delivery rates.
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