Determinants of Maternal Home Delivery in Nigeria: Evidence for Targeted Health Policy Interventions
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834-850
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10.58578/ijhess.v3i3.6534
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Authors:
Matthew Ayegboyin1* 
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Main Article Content
Abstract
Maternal mortality remains a critical public health concern globally, with Nigeria bearing the highest burden of avoidable maternal deaths despite a global decline in the maternal mortality ratio. A significant proportion of these deaths occur during childbirth, often linked to home deliveries. Although several maternal health policies and programs have been introduced to promote facility-based deliveries, a large number of Nigerian women continue to give birth at home. This study investigates the determinants of home delivery among Nigerian women to inform health policy aimed at reducing maternal mortality. Utilizing data from the 2018 Nigeria Demographic and Health Survey (NDHS), a filtered sample of 41,821 women aged 15–49 was analyzed using SPSS version 27. Descriptive and bivariate statistical techniques were employed to identify key influencing factors. The findings reveal that home delivery is most prevalent among teenage mothers (63.1%), uneducated women (82.4%), the poorest socioeconomic group (75.7%), rural residents (63.8%), and women in the northwest region (83.4%). Language barriers also emerged as a significant determinant of home delivery. The study recommends the development of state-specific policies to train Traditional Birth Attendants (TBAs) at no cost, particularly in rural and underserved communities, to improve maternal health outcomes and reduce reliance on unsafe home deliveries.
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References
Abubakar, S., Adamu, D., Hamza, R., & Galadima, J. B. (2017). Determinants of Home Delivery among Women attending Antenatal Care in Bagwai Town, Kano Nigeria. Afr J Reprod Health, 21(4), 73-79. https://doi.org/10.29063/ajrh2017/v21i4.8
Adde, K. S., Dickson, K. S., & Amu, H. (2020). Prevalence and determinants of the place of delivery among reproductive age women in sub-Saharan Africa. PLoS One, 15(12), e0244875. https://doi.org/10.1371/journal.pone.0244875
Adewuyi, E. O., Khanal, V., Zhao, Y., David, L., Bamidele, O. D., & Auta, A. (2019). Home childbirth among young mothers aged 15-24 years in Nigeria: a national population-based cross-sectional study. BMJ Open, 9(9), e025494. https://doi.org/10.1136/bmjopen-2018-025494
Ajayi, A. I., Ahinkorah, B. O., & Seidu, A. A. (2023). "I don't like to be seen by a male provider": health workers' strike, economic, and sociocultural reasons for home birth in settings with free maternal healthcare in Nigeria. Int Health, 15(4), 435-444. https://doi.org/10.1093/inthealth/ihac064
Ajayi, A. I., & 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. https://doi.org/10.1186/s12889-020-08512-z
Aregbeshola, B. S., & Khan, S. M. (2017). Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti's Leadership. Front Public Health, 5, 48. https://doi.org/10.3389/fpubh.2017.00048
Asirifi, S. K. A., Kolbilla, D. Z., Boateng, K.-H. T., Prince, N., Dammigu, K. E., & Yumann, K. J. (2025). Factors Influencing the Choice of Delivery Places by Pregnant Women in Selected Health Facilities in the Sagnarigu Municipality. Asian Journal of Pregnancy and Childbirth, 8(1), 133-149. https://doi.org/10.9734/ajpcb/2025/v8i1154
Babalola, S., & Fatusi, A. (2009). Determinants of use of maternal health services in Nigeria--looking beyond individual and household factors. BMC Pregnancy Childbirth, 9, 43. https://doi.org/10.1186/1471-2393-9-43
Dahie, H. A., Osman, M. A., Jimale, Y. A., Mohamud, F. I., Hussein, H. A., Alasow, M. O., Osman, A. A., Abdirahman Mohamed, A., Dakane, M. M., & Hussein, D. A. (2025). Determinants of institutional delivery service utilization among internally displaced vulnerable populations in Benadir region, Somalia: A community based cross-sectional study. J Migr Health, 11, 100319. https://doi.org/10.1016/j.jmh.2025.100319
Dauda, R. (2023). Maternal Mortality in Nigeria: What is Known and What Needs to be Done.
Dickson, K. S., Adde, K. S., & Amu, H. (2016). What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana. Int J Reprod Med, 2016, 7203980. https://doi.org/10.1155/2016/7203980
Dogbanya, G. (2025). Maternal Mortality in Nigeria: Holding the Line in Uncertain Times. Ann Glob Health, 91(1), 16. https://doi.org/10.5334/aogh.4710
Esan, D. T., Ayenioye, O. H., Ajayi, P. O., & Sokan-Adeaga, A. A. (2023). Traditional birth attendants' knowledge, preventive and management practices for postpartum haemorrhage in Osun State, Southwestern Nigeria. Sci Rep, 13(1), 12314. https://doi.org/10.1038/s41598-023-39296-y
Eze, O. I., & Chukwuma, I. F. (2024). Does expanding health insurance in rural Nigeria result in improved health outcomes and poverty reduction? Journal of Global Health Economics and Policy, 4. https://doi.org/10.52872/001c.125491
Fentie, T. A., Solomon, A. A., Enyew, M. M., Beyene, M. M., Melese, A. K., Belay, A. E., & Alemu, G. G. (2025). Respectful maternity care and associated factors among mothers who gave birth at public health institutions in Debre Tabor town, Northwest Ethiopia: a mixed-methods study. Front Glob Womens Health, 6, 1513906. https://doi.org/10.3389/fgwh.2025.1513906
Hassan, I., Philip, E., Michael, A., Joshua, A., & al., e. (2021). Factors Determining the Choice of Place of Delivery among Antenatal Attendees in Primary Health Care Centres in Lafia Nigeria. Texila International Journal of Public Health, 9(3). https://doi.org/10.21522/TIJPH.2013.09.03.Art0015
Izugbara, C. O., & Wekesah, F. (2018). What does quality maternity care mean in a context of medical pluralism? Perspectives of women in Nigeria. Health Policy Plan, 33(1), 1-8. https://doi.org/10.1093/heapol/czx131
Jiwani, S. S., Cisse, K., Mutua, M., & al, e. (2025). Levels and Determinants of Person-Centered Maternity Care Among Women Living in Urban Informal Settlements: Evidence from Client Exit Surveys in Nairobi, Lusaka and Ouagadougou. https://doi.org/10.1101/2025.01.09.25320278
Johnson, O. E., Obidike, P. C., Eroh, M. U., Okpon, A. A., Bassey, E. I., Patrick, P. C., Ebong, P. E., & 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. https://doi.org/10.4103/npmj.npmj_150_19
NPC, & ICF. (2019). Nigeria Demographic and Health Survey 2018.
Ntoimo, L. F. C., Okonofua, F. E., Ekwo, C., Solanke, T. O., Igboin, B., Imongan, W., & Yaya, S. (2022). Why women utilize traditional rather than skilled birth attendants for maternity care in rural Nigeria: Implications for policies and programs. Midwifery, 104, 103158. https://doi.org/10.1016/j.midw.2021.103158
Ntoimo, L. F. C., Okonofua, F. E., Igboin, B., Ekwo, C., Imongan, W., & Yaya, S. (2019). Why rural women do not use primary health centres for pregnancy care: evidence from a qualitative study in Nigeria. BMC Pregnancy Childbirth, 19(1), 277. https://doi.org/10.1186/s12884-019-2433-1
Okeke, C. I., Ochie, C., Mbachu, C., & Onwasigwe, C. (2025). Examining demand and supply factors associated with women’s preferences for where to deliver their babies in rural and urban communities of Enugu State, Nigeria. Discover Public Health, 22(1). https://doi.org/10.1186/s12982-025-00462-4
Oladele, R., Ojo, E., Okoduwa, G. E., Olajide, O. A., Olufadewa, I., & Adesina, M. (2024). Utilization of antenatal care by young mothers and adolescents in Nigeria. Discover Public Health, 21(1). https://doi.org/10.1186/s12982-024-00335-2
Olowolafe, T. A., Adebowale, A. S., Fagbamigbe, A. F., Bolarinwa, O. A., & Akinyemi, J. O. (2023). Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018. PLoS One, 18(1), e0279365. https://doi.org/10.1371/journal.pone.0279365
Omuta, G., Onokerhoraye, A., Okonofua, F., Obanovwe, G., Isah, E., Okoro, J., Onojeta, F., Omoraka, F., Eregare, J., & kpomera, E. (2014). PERSPECTIVES ON PRIMARY HEALTH CARE IN NIGERIA: PAST, PRESENT AND FUTURE. In CPED Monograph Series 10.
Onyema, A., & Isokon, B. (2024). Teenage pregnancy and socio-economic implications for adolescents in southern senatorial district of cross river state, Nigeria. International Journal of Intellectual Discourse (IJID), 7(1), 12.
Oyedele, O. K. (2023). Disparities and barriers of health facility delivery following optimal and suboptimal pregnancy care in Nigeria: evidence of home births from cross-sectional surveys. BMC Womens Health, 23(1), 194. https://doi.org/10.1186/s12905-023-02364-6
Sabo, A., Alzoubi, M. M., Saidu, A. Y., Usman, U. S., Saulawa, I. M., Al-Mugheed, K., Farghaly Abdelaliem, S. M., & Saeed Alabdullah, A. A. (2024). Determinants of Utilization of Antenatal Care Services Among Women of Childbearing Age in Jigawa State, Nigeria. Int J Public Health, 69, 1607385. https://doi.org/10.3389/ijph.2024.1607385
Salami, K. K., & Ayegboyin, M. (2014). Intergenerational Life Courses of Teenage Pregnancy in Ogbomosho South‐Western Nigeria. Children & Society, 29(5), 451-461. https://doi.org/10.1111/chso.12078
Salami, K. K., Ayegboyin, M., & Adedeji, I. A. (2014). Unmet social needs and teenage pregnancy in Ogbomosho, South-western Nigeria. Afr Health Sci, 14(4), 959-966. https://doi.org/10.4314/ahs.v14i4.27
Samuel, G. K., & Okpe, O. (2024). Socio-demographic Determinants of Healthcare Utilization among Adults in Rural Communities of Benue State, Nigeria. Asian Journal of Medicine and Health, 22(8), 147-157. https://doi.org/10.9734/ajmah/2024/v22i81080
Solanke, B. L., Salau, O. R., Popoola, O. E., Adebiyi, M. O., & Ajao, O. O. (2019). Socio-demographic factors associated with delayed childbearing in Nigeria. BMC Res Notes, 12(1), 374. https://doi.org/10.1186/s13104-019-4414-x
Tekeba, B., Zegeye, A. F., Gebrehana, D. A., & Tamir, T. T. (2025). Prevalence and Determinants of Home Delivery among Women with Easy Access to Health Facilities in Sub Saharan African Countries: A Multi level Mixed Effect Analysis. Ann Glob Health, 91(1), 5. https://doi.org/10.5334/aogh.4615
Udenigwe, O., Okonofua, F. E., Ntoimo, L. F. C., Imongan, W., Igboin, B., & Yaya, S. (2021). "We have either obsolete knowledge, obsolete equipment or obsolete skills": policy-makers and clinical managers' views on maternal health delivery in rural Nigeria. Fam Med Community Health, 9(3). https://doi.org/10.1136/fmch-2021-000994
UNICEF. (2025). The State of Nigeria’s Children: Summary of the 2024 Situation Analysis of Children and Adolescents in Nigeria, second edition. Federal Government of Nigeria and United Nations Children’s Fund Nigeria.
WHO. (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
WHO. (2023). Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. World Health Organization.
WHO. (2024). World health statistics 2024: monitoring health for the SDGs, Sustainable Development Goals.
WHO, & UNICEF. (2017). World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) discussion paper: the extension of the 2025 maternal, infant and young child nutrition targets to 2030.
Yaya, S., Bishwajit, G., & Gunawardena, N. (2019). Socioeconomic factors associated with choice of delivery place among mothers: a population-based cross-sectional study in Guinea-Bissau. BMJ Glob Health, 4(2), e001341. https://doi.org/10.1136/bmjgh-2018-001341
Zegeye, A. T., Tilahun, B. C., Fekadie, M., Addisu, E., Wassie, B., Alelign, B., Sharew, M., Baykemagn, N. D., Kebede, A., & Yehuala, T. Z. (2025). Predicting home delivery and identifying its determinants among women aged 15-49 years in sub-Saharan African countries using a Demographic and Health Surveys 2016-2023: a machine learning algorithm. BMC Public Health, 25(1), 302. https://doi.org/10.1186/s12889-025-21334-1