When Women Deliver with No One Present in Nigeria: Who, What, Where and So What?
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Auteurs : Bolaji M. Fapohunda [États-Unis] ; Nosakhare G. Orobaton [États-Unis, Nigeria]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
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.
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DOI: 10.1371/journal.pone.0069569
PubMed: 23936047
PubMed Central: 3723888
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Orobaton</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>International Division, John Snow, Incorporated, Rosslyn, Virginia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>International Division, John Snow, Incorporated, Rosslyn, Virginia</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State, Nigeria</addr-line></nlm:aff><country xml:lang="fr">Nigeria</country><wicri:regionArea>Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Doctor, Hv" uniqKey="Doctor H">HV Doctor</name></author><author><name sortKey="Findley, Se" uniqKey="Findley S">SE Findley</name></author><author><name sortKey="Ager, A" uniqKey="Ager A">A Ager</name></author><author><name sortKey="Cometto, G" uniqKey="Cometto G">G Cometto</name></author><author><name sortKey="Afenyadu, Gy" uniqKey="Afenyadu G">GY Afenyadu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abimbola, S" uniqKey="Abimbola S">S Abimbola</name></author><author><name sortKey="Okoli, U" uniqKey="Okoli U">U Okoli</name></author><author><name sortKey="Olubajo, O" uniqKey="Olubajo O">O Olubajo</name></author><author><name sortKey="Abdullahi, Mj" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23936047</article-id><article-id pub-id-type="pmc">3723888</article-id><article-id pub-id-type="publisher-id">PONE-D-13-13812</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0069569</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Clinical Research Design</subject><subj-group><subject>Statistical Methods</subject><subject>Survey Research</subject></subj-group></subj-group><subj-group><subject>Epidemiology</subject><subj-group><subject>Survey Methods</subject></subj-group></subj-group><subj-group><subject>Global Health</subject></subj-group><subj-group><subject>Non-Clinical Medicine</subject><subj-group><subject>Health Care Policy</subject><subj-group><subject>Health Education and Awareness</subject></subj-group></subj-group><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group><subj-group><subject>Obstetrics and Gynecology</subject><subj-group><subject>Labor and Delivery</subject></subj-group></subj-group><subj-group><subject>Public Health</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Social and Behavioral Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Demography</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>When Women Deliver with No One Present in Nigeria: Who, What, Where and So What?</article-title><alt-title alt-title-type="running-head">When Women Deliver with No One Present</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Fapohunda</surname><given-names>Bolaji M.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Orobaton</surname><given-names>Nosakhare G.</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>International Division, MEASURE Evaluation, John Snow, Incorporated, Rosslyn, Virginia, United States of America</addr-line></aff><aff id="aff2"><label>2</label><addr-line>International Division, John Snow, Incorporated, Rosslyn, Virginia, United States of America</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State, Nigeria</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Leone</surname><given-names>Tiziana</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>London School of Economics, United Kingdom</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>bfapohunda@jsi.com</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>The authors have read the journal’s policy and have the following conflicts: the two authors are employed by JSI, which is a commercial company. This involvement does not alter their adherence to all the PLOS ONE policies on sharing data and materials.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: BF NO. Performed the experiments: BF NO. Analyzed the data: BF NO. Contributed reagents/materials/analysis tools: BF NO. Wrote the paper: BF NO. Implemented statistical estimation of the indicators, interpreted data and results, did the literature review, developed the methodology, drafted the paper and coordinated the revisions: BF. Provided conceptual and technical guidance, contributed towards the interpretation of findings, helped to develop key messages, and contributed to the drafts and revisions: NO.</p></fn></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>25</day><month>7</month><year>2013</year></pub-date><volume>8</volume><issue>7</issue><elocation-id>e69569</elocation-id><history><date date-type="received"><day>4</day><month>4</month><year>2013</year></date><date date-type="accepted"><day>13</day><month>6</month><year>2013</year></date></history><permissions><copyright-year>2013</copyright-year><copyright-holder>Fapohunda, Orobaton</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><p>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.</p></abstract><funding-group><funding-statement>Funding was provided by USAID/Nigeria (<ext-link ext-link-type="uri" xlink:href="http://www.usaid.org">www.usaid.org</ext-link>). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><page-count count="12"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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