Women’s Awareness of Obstetric Complications, Preparations for Delivery and Utilization of Skilled Birth Attendants in Northern Nigeria

Henry V. Doctor, Columbia University
Sally E. Findley, Columbia University
Giorgio Cometto, Save the Children UK

Maternal and child health outcomes in Nigeria are among the worst in the world, and insufficient receipt of high-quality antenatal, delivery, and postnatal services is likely a central determinant of these outcomes. To better understand the pathways through which socio-demographic environment affects awareness of obstetric complications and access to skilled birth attendants, we conducted a survey in 2009 of 7,442 women in three northern Nigerian states where conditions are particularly grim. Results show that 14 percent of women knew critical pregnancy complications whereas 32 percent knew critical labor and delivery complications. Women’s status (measured by ability to earn cash income), antenatal care attendance, and preparations for delivery were significant factors in influencing awareness of critical obstetric complications. Women who earned cash income were 1.75 times more likely to know critical maternal complications than their counterparts. We interpret these results and provide recommendations applicable to northern Nigeria and other similar settings.