Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 13;19(6):e0304856.
doi: 10.1371/journal.pone.0304856. eCollection 2024.

Perception and reasons for the choice of informal provider among women receiving antenatal care services from traditional birth attendants in rural communities of Lagos state, Nigeria

Esther O Oluwole  1 , Tolulope E Oluwadumila  1 , Ifeoma P Okafor  1 , Abiola O Temitayo-Oboh  2
Affiliations

Perception and reasons for the choice of informal provider among women receiving antenatal care services from traditional birth attendants in rural communities of Lagos state, Nigeria

Esther O Oluwole et al. PLoS One. .

Abstract

Background: Unskilled delivery, particularly the use of traditional birth attendants, is a major threat to reducing maternal mortality in Africa. Despite the associated risks, there is insufficient evidence on the major reasons why pregnant women in Nigeria continue to use traditional birth attendant (TBA) services, especially in rural areas. This study, therefore, assessed the perception, reasons for use, and utilization of only TBA services in current pregnancy among rural-dwelling pregnant women in Lagos, Nigeria.

Methods: A descriptive cross-sectional study was conducted among 347 pregnant women recruited from traditional birth attendant facilities at Ikorodu Local Government Area, Lagos. Data were collected with an interviewer-administered questionnaire and analyzed using SPSS version 25. Bivariate and multivariate analyses were conducted with a significance level set at p<0.05. The outcome measures included perception, utilization of only TBA services in current pregnancy, and reasons for use. Positive perception refers to positive thought, belief, or opinion held by the participants towards the TBA.

Results: All the respondents had a positive perception of TBAs, majority (70.3%) utilized TBA only while 29.7% combined TBA and healthcare facilities services in the current pregnancy. Recommendations from previous users (81.6%), welcoming and hospitable staff (77.2%), perceived spiritual protection (75.2%), and past use (68.6%), were some of the reasons cited by the respondents for utilizing only TBA services. Predictors of utilizing only TBA services were respondents' level of education, those with secondary (aOR = 0.261; 95% CI; 0.108-0.629) and tertiary (aOR = 0.352; 95% CI; 0.162-0.769) had lower utilization while the lack of health insurance coverage (aOR = 3.017; 95% CI; 1.476-6.166) were associated with higher utilization of TBAs.

Conclusion: Respondents in this study had a positive perception of TBA services. Continuous training and an effective monitoring system of TBAs by the government and other healthcare stakeholders to improve women's birthing experiences is recommended.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overall Perception of respondents towards the services of TBA.
Fig 2
Fig 2. Respondents’ reasons for utilizing TBA services in the current pregnancy.
See this image and copyright information in PMC

References

    1. WHO, UNICEF, UNFPA, Word Bank Group, and the United Nations Population Division. Maternal mortality: Levels and trends 2000 to 2017. Geneva: 2019. [Cited 2023 October 27]. www.who.int/reproductivehealth/pubications/maternal-mortality-2000-2017/en/
    1. World Health Organization. World health statistics 2019: Monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2019. [Cited 2023 September 23]. https://apps.who.int/iris/bitsream/handle/10665/324835/9789241565707-eng...
    1. Dickson KS, Amu H. Determinants of skilled birth attendance in the northern parts of Ghana. Advances in Public Health. 2017;4(1):1–8. doi: 10.115/2017/9102808 - DOI
    1. Afulani PA, Moyer C. Explaining disparities in use of skilled birth attendants in developing countries: a conceptual framework. PLoS One. 2016. 22;11(4):e0154110. doi: 10.1371/journal.pone.0154110 - DOI - PMC - PubMed
    1. Awotunde O, Adesina SA, Fehintola A, Ajala D. Determinants of the utilization of traditional birth attendant services by pregnant women in Ogbomoso, Nigeria. International Journal of Reproduction, Contraception, Obstetrics, and Gynaecology. 2017;6(7):268. doi: 10.18203-2320-1770.ijrcog20172894