Credit: Francis Tokede
In Nigeria, the place of delivery for women giving birth varies significantly depending on location and the type of facility. According to the Nigeria MICS (Multiple Indicator Cluster Survey) 2021, approximately half of women aged 15-49 years gave birth in both public and private facilities, while the rest used either a public facility or a private facility for their most recent live birth.
In urban areas, the proportion of women giving birth in private facilities is higher than that of women in rural areas. Around 30.2% of women in urban areas gave birth in private facilities, while only 8.3% of women in rural areas did. On the other hand, the percentage of women delivering in public facilities was higher in rural areas, with 26.2% of women delivering there, compared to 44.1% in urban areas.
Overall, the use of both public and private facilities is more common in Nigeria than using only public or private facilities for giving birth. It's important to note that accessing health care in rural areas can be challenging due to factors such as limited infrastructure, transportation, and finances. However, there have been efforts to improve the availability and quality of health facilities in Nigeria, particularly in rural areas, to encourage women to give birth in safer and more hygienic conditions.
The distribution of women using public, private, or both facilities for giving birth also varies depending on other factors such as socioeconomic status, education level, and marital status. These factors can impact access to and utilization of health care services, and efforts should be made to ensure that all women, regardless of their background, have access to safe and reliable health care for delivering their babies.
For instance, the level of education of women giving birth in Nigeria also plays a significant role in determining the place of delivery, as seen in the Nigeria MICS 2021 data on the percentage distribution of women with a live birth in the last 2 years by place of delivery according to education level.
The data shows that women with higher levels of education are more likely to give birth in both public and private facilities, with 91.1% of women with higher/tertiary education giving birth in both facilities, compared to 19.5% of women with no education.
As the education level increases, the percentage of women giving birth in private facilities also increases, from 2.2% for women with no education to 39.2% for women with higher/tertiary education. The percentage of women giving birth in public facilities also increases as education level increases, from 17.3% for women with no education to 51.9% for women with higher/tertiary education.
Women with primary, junior secondary, and senior secondary education levels have a higher percentage of births in both public and private facilities compared to those who have no education. However, the percentage of women delivering in private facilities is still relatively low, ranging from 11.1% for women with primary education to 28.6% for women with senior secondary education.
The level of education plays a significant role in determining the place of delivery for women in Nigeria. Women with higher levels of education are more likely to give birth in both public and private facilities, while women with no education are more likely to deliver in public facilities only. Efforts to improve access to education and promote female education in Nigeria could help increase the number of women giving birth in both public and private facilities, which can improve maternal and infant health outcomes.
The geopolitical zone in which women give birth in Nigeria also plays a significant role in determining the place of delivery. According to the Nigeria MICS 2021 data on the percentage distribution of women with a live birth in the last 2 years by place of delivery according to geographic zone, the South East zone has the highest percentage of women giving birth in both public and private health facilities, with 91.3% of women giving birth in these facilities.
The South West zone has the second-highest percentage of women giving birth in both public and private health facilities, at 79.3%. The North Central zone has the third-highest percentage, with 59.4% of women giving birth in both public and private health facilities.
In contrast, the North West zone has the lowest percentage of women giving birth in both public and private health facilities, at 20.6%. The North East zone also has a relatively low percentage, with 34.2% of women giving birth in both public and private health facilities. The South South zone has a slightly higher percentage of women giving birth in both public and private health facilities, at 62.7%.
It's important to note that the distribution of women giving birth in both public and private health facilities may be influenced by various factors, including the availability and accessibility of health facilities, cultural and religious beliefs, socioeconomic status, and education level.
Efforts to improve the availability and quality of health facilities in the North West and North East zones, which have relatively low percentages of women giving birth in both public and private health facilities, could help improve maternal and infant health outcomes in these regions. Additionally, addressing cultural and religious beliefs that may hinder women from accessing health care services could also help increase the number of women giving birth in both public and private health facilities.
The percentage of women giving birth at a health facility varies across the states in Nigeria, with some states having a significantly higher percentage than others. According to the Nigeria MICS 2021 data on the percentage of women age 15-49 years with a live birth in the last 2 years who gave birth in a health facility by state, the state with the highest percentage of women giving birth at a health facility is Imo, at 93.8%. The next highest percentages are in Abia (91.2%), Anambra (90.8%), and Ebonyi (90.7%).
In general, states in the Southeast region of Nigeria have higher percentages of women giving birth at health facilities, with Enugu, Edo, and Osun also having high percentages. Lagos, the most populous state in Nigeria, has a relatively high percentage of women giving birth at a health facility, at 86.7%. Kogi and FCT Abuja, both located in central Nigeria, also have relatively high percentages.
On the other hand, states in the Northern region of Nigeria generally have lower percentages of women giving birth at health facilities, with Katsina, Zamfara, Sokoto, and Jigawa having the lowest percentages. Bauchi, Taraba, and Kano also have low percentages, with less than a third of women giving birth at a health facility in these states.
These variations in the percentage of women giving birth at a health facility by state may be due to factors such as the availability and accessibility of health facilities, cultural and religious beliefs, and education and socioeconomic status. Efforts to improve access to and the quality of health facilities, as well as address cultural and religious beliefs that may hinder women from accessing health care services, could help increase the number of women giving birth at health facilities in these states with lower percentages.
In conclusion, while the use of both public and private facilities for giving birth is common in Nigeria, the percentage of women using these facilities varies based on location, socioeconomic status, education, and marital status. Efforts to improve health care infrastructure and access in rural areas can help ensure that women in these areas have access to safe and hygienic birthing conditions, which can help reduce maternal and infant mortality rates in the country.