Child-birth is a risk producing event that requires timely and adequate medical intervention for women who experience obstetric complications. The provision of a health worker with midwifery skills at every birth, plus access to emergency hospital obstetric care, is the option to mitigate this risk. However, in sub Saharan Africa, most births take place outside health facilities and without skilled attendants. This study aimed to determine and compare the factors which influence the choice of place of delivery among women in an urban and a rural community in Sokoto. It was a cross-sectional comparative study of 600 randomly selected women of reproductive age, in Sokoto South and Gwadabawa Local Government Areas of Sokoto State, Nigeria using semi-structured interviewer administered questionnaires. The proportion of women who delivered in health facilities was 65.0 and 4.7% in the urban and rural groups, respectively; whereas the proportion that had skilled attendants at delivery was 70 and 4.3% in the urban and rural groups, respectively. Lack of consent from husband, no privacy in health facilities, distance to the health facility and non-availability of delivery wards were the reasons for home deliveries in the rural study group, while the emergency nature of labour was the reason in the urban group. Women residing in rural areas need health promotion interventions in order to meet the International Conference on Population and Development + target of achieving 90% births attended by skilled attendants by 2015.
Key words: Determinants, place of delivery, skilled attendant, urban and rural, Sokoto.
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