What is it about?

Nigeria currently accounts for the highest absolute number of maternal mortalities, globally. This notwithstanding, facility delivery is under-utilized with the prevalence of home delivery as high 63% as in the country. More importantly, adolescents and young mothers (aged 15 to 24 years) are known to be more vulnerable to greater risks of social, health challenges as well as maternal mortality. Previous studies having focused more on all women of reproductive age, research on factors contributing to the risk of home delivery among young mothers are limited in Nigeria. The present study aimed to bridge the existing knowledge gaps by assessing the prevalence and factors associated with home childbirth among adolescents and young mothers aged 15 – 24 years in Nigeria using nationally representative data. Our findings reveal approximately 70% prevalence of home delivery among young mothers aged 15 – 24 years in Nigeria. This prevalence is higher than the reported national average of 63% for all women of reproductive age in the country. Using the well-regarded Andersen’s model, two environmental factors (rural-urban residence and regions), six predisposing factors (maternal and husband’s education level, maternal religion, wealth index, parity and access to radio) as well as three enabling factors (antenatal visits, health insurance and distance to health facility) were significantly associated with home delivery. Adolescents and young mothers residing in rural areas, North-West, North-East and South-South regions had greater prevalence and likelihood of home delivery than their counterparts in urban areas and the South-West region of the country. Similarly, the prevalence and likelihood of home delivery were significantly higher among mothers in poor households, non-educated mothers as well as mothers whose husbands were not educated. Listening to radio programs for at least once a week and access to health insurance reduced the chances of home delivery just as attending antenatal care services. Mothers who had difficulty with distance to a health facility, as well as those with Islamic affiliation, were more likely to deliver their babies at home.

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Why is it important?

Utilizing healthcare facility for childbirth is critical for reducing maternal and neonatal mortalities, worldwide. The reason for this premise is well substantiated. Most incidences of maternal and neonatal deaths relate to obstetric complications and occur majorly during delivery or a few days thereafter. Obstetric complications are difficult to predict; however, they are preventable or treatable in healthcare facilities. By utilizing healthcare facility for childbirth, therefore, several needless maternal mortalities could be prevented—underpinning the importance of health facility delivery.


Based on our findings, a multifaceted approach including education, socioeconomic empowerment, access to health insurance, faith-based health promotion, elimination of early/child marriage and a youth-oriented antenatal package may help to address the challenge of home delivery among young mothers aged 15 to 24 years in Nigeria.

Emmanuel O Adewuyi
Queensland University of Technology

Read the Original

This page is a summary of: Home childbirth among young mothers aged 15–24 years in Nigeria: a national population-based cross-sectional study, BMJ Open, September 2019, BMJ, DOI: 10.1136/bmjopen-2018-025494.
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