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Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria

Received: 22 January 2021    Accepted: 17 February 2021    Published: 27 February 2021
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Abstract

Background: Nigeria faces high maternal and infant mortality; and Nigeria is one of the two countries, with India, that account for one-third of global child mortality. Many deaths could be prevented by institutional delivery, yet many women especially in developing countries still deliver a baby at home. Nigeria is not an exception; it faces low rate of institutional delivery, only 35.8%. Objective: To identify why many women do not deliver at a clinic, we compare the advantages and disadvantages of each place – home and clinic – for childbirth. Method: We conducted a qualitative study among 86 women in northern Nigeria. Data were analyzed using inductive content analysis. Result: Among women who delivered a baby at home, the main barriers to institutional delivery include misconception about the importance, unpleasant clinic environment, and perceived harsh attitudes of health staff. One advantage of home delivery is the emotional support from family. Most women who delivered at clinic are satisfied with their experiences with no complaint about harsh staff attitude. The main disadvantages of clinic delivery is the condition of the clinic. Conclusion: The low quality of care at the health clinics is a concern and should be improved. Providing women with emotional support and pleasant environment at clinic are two feasible and potentially effective options.

Published in European Journal of Preventive Medicine (Volume 9, Issue 1)
DOI 10.11648/j.ejpm.20210901.14
Page(s) 19-24
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Barriers to Institutional Delivery, Advantages of Home Delivery, Northern Nigeria, Emotional Support

References
[1] WHO, UNICEF, UNFPA, World Bank Group, et al. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, 2015.
[2] United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & Trends in Child Mortality: Report 2017, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. United Nations Children’s Fund, New York, 2017.
[3] Kerber K, E de Graft-Johnson J, Bhutta Z, Okong P, et al. Continuum of care for maternal, newborn and child health: from slogan to service deliver. Lancet. 2007; 370: 1358-69. doi: 10.1016/S0140-6736(07)61578-5.
[4] National Population Commission (NPC) [Nigeria] and ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International, 2014.
[5] Vellakkal S, Reddy H, Gupta A, Chandran A, et al. A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program. Social Science and Medicine. 2017; 178: 55–65.
[6] Wilunda C, Quaglio G, Putoto G, Lochoro P, et al. A qualitative study on barriers to utilisation of institutional delivery services in Moroto and Napak districts, Uganda: implications for programming. 2014; 4 (14) 259 doi: 10.1186/1471-2393-14-259.
[7] Wilunda C, Scanagatta C, Putoto G, Takahashi R, et al. Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study. PLOS ONE. 2016; 11 (12): e0168083. https://doi.org/10.1371/journal.pone.0168083
[8] Dahab, Rana, and Dikaios Sakellariou. "Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review." International journal of environmental research and public health 17, no. 12 (2020): 4292.
[9] Tey, Nai-Peng, and Siow-li Lai. "Correlates of and barriers to the utilization of health services for delivery in South Asia and Sub-Saharan Africa." The Scientific World Journal 2013 (2013).
[10] Kyei-Nimakoh, Minerva, Mary Carolan-Olah, and Terence V. McCann. "Access barriers to obstetric care at health facilities in sub-Saharan Africa—a systematic review." Systematic reviews 6, no. 1 (2017): 1-16.
[11] Hernandez, Bernardo, Danny V. Colombara, Marielle C. Gagnier, Sima S. Desai, Annie Haakenstad, Casey Johanns, Claire R. McNellan et al. "Barriers and facilitators for institutional delivery among poor Mesoamerican women: a cross-sectional study." Health policy and planning 32, no. 6 (2017): 769-780.
[12] Harahap, Nabila Clydea, Putu Wuri Handayani, and Achmad Nizar Hidayanto. "Barriers and technologies of maternal and neonatal referral system in developing countries: a narrative review." Informatics in Medicine Unlocked 15 (2019): 100184.
[13] Limwattananon, Supon, Viroj Tangcharoensathien, and Supakit Sirilak. "Trends and inequities in where women delivered their babies in 25 low-income countries: evidence from Demographic and Health Surveys." Reproductive Health Matters 19, no. 37 (2011): 75-85.
[14] Hasan, Md Mehedi, Ricardo J. Soares Magalhaes, Yaqoot Fatima, Saifuddin Ahmed, and Abdullah A. Mamun. "Levels, Trends, and Inequalities in Using Institutional Delivery Services in Low-and Middle-Income Countries: A Stratified Analysis by Facility Type." Global Health: Science and Practice (2021).
[15] Bohren, Meghan A., Erin C. Hunter, Heather M. Munthe-Kaas, João Paulo Souza, Joshua P. Vogel, and A. Metin Gülmezoglu. "Facilitators and barriers to facility-based delivery in low-and middle-income countries: a qualitative evidence synthesis." Reproductive health 11, no. 1 (2014): 1-17.
Cite This Article
  • APA Style

    Ryoko Sato, Yoshito Takasaki. (2021). Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria. European Journal of Preventive Medicine, 9(1), 19-24. https://doi.org/10.11648/j.ejpm.20210901.14

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    ACS Style

    Ryoko Sato; Yoshito Takasaki. Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria. Eur. J. Prev. Med. 2021, 9(1), 19-24. doi: 10.11648/j.ejpm.20210901.14

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    AMA Style

    Ryoko Sato, Yoshito Takasaki. Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria. Eur J Prev Med. 2021;9(1):19-24. doi: 10.11648/j.ejpm.20210901.14

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  • @article{10.11648/j.ejpm.20210901.14,
      author = {Ryoko Sato and Yoshito Takasaki},
      title = {Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria},
      journal = {European Journal of Preventive Medicine},
      volume = {9},
      number = {1},
      pages = {19-24},
      doi = {10.11648/j.ejpm.20210901.14},
      url = {https://doi.org/10.11648/j.ejpm.20210901.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20210901.14},
      abstract = {Background: Nigeria faces high maternal and infant mortality; and Nigeria is one of the two countries, with India, that account for one-third of global child mortality. Many deaths could be prevented by institutional delivery, yet many women especially in developing countries still deliver a baby at home. Nigeria is not an exception; it faces low rate of institutional delivery, only 35.8%. Objective: To identify why many women do not deliver at a clinic, we compare the advantages and disadvantages of each place – home and clinic – for childbirth. Method: We conducted a qualitative study among 86 women in northern Nigeria. Data were analyzed using inductive content analysis. Result: Among women who delivered a baby at home, the main barriers to institutional delivery include misconception about the importance, unpleasant clinic environment, and perceived harsh attitudes of health staff. One advantage of home delivery is the emotional support from family. Most women who delivered at clinic are satisfied with their experiences with no complaint about harsh staff attitude. The main disadvantages of clinic delivery is the condition of the clinic. Conclusion: The low quality of care at the health clinics is a concern and should be improved. Providing women with emotional support and pleasant environment at clinic are two feasible and potentially effective options.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Advantages and Disadvantages of Institutional Delivery and Home Delivery: A Qualitative Study in Northern Nigeria
    AU  - Ryoko Sato
    AU  - Yoshito Takasaki
    Y1  - 2021/02/27
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ejpm.20210901.14
    DO  - 10.11648/j.ejpm.20210901.14
    T2  - European Journal of Preventive Medicine
    JF  - European Journal of Preventive Medicine
    JO  - European Journal of Preventive Medicine
    SP  - 19
    EP  - 24
    PB  - Science Publishing Group
    SN  - 2330-8230
    UR  - https://doi.org/10.11648/j.ejpm.20210901.14
    AB  - Background: Nigeria faces high maternal and infant mortality; and Nigeria is one of the two countries, with India, that account for one-third of global child mortality. Many deaths could be prevented by institutional delivery, yet many women especially in developing countries still deliver a baby at home. Nigeria is not an exception; it faces low rate of institutional delivery, only 35.8%. Objective: To identify why many women do not deliver at a clinic, we compare the advantages and disadvantages of each place – home and clinic – for childbirth. Method: We conducted a qualitative study among 86 women in northern Nigeria. Data were analyzed using inductive content analysis. Result: Among women who delivered a baby at home, the main barriers to institutional delivery include misconception about the importance, unpleasant clinic environment, and perceived harsh attitudes of health staff. One advantage of home delivery is the emotional support from family. Most women who delivered at clinic are satisfied with their experiences with no complaint about harsh staff attitude. The main disadvantages of clinic delivery is the condition of the clinic. Conclusion: The low quality of care at the health clinics is a concern and should be improved. Providing women with emotional support and pleasant environment at clinic are two feasible and potentially effective options.
    VL  - 9
    IS  - 1
    ER  - 

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Author Information
  • Harvard T. H. Chan School of Public Health, Harvard University, Boston, USA

  • Graduate School of Economics, University of Tokyo, Tokyo, Japan

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