Bola Lukman Solanke|Semiu Adebayo Rahman
Multilevel analysis of factors associated with assistance during delivery in rural Nigeria: implications for reducing rural-urban inequity in skilled care at delivery
Obafemi Awolowo University|Obafemi Awolowo University
studies observed ruralurban inequity use skilled delivery nigeria number studies explicitly examined associated factors assistance delivery rural areas however studies far conducted rural nigeria investigated mainly individuallevel characteristics near exclusion communitylevel characteristics also studies investigated communitylevel influence use maternal healthcare services nigeria isolate rural areas specific research attention objective study investigate individuallevel communitylevel characteristics associated assistance delivery rural nigeriathe study analysed women data 2013 nigeria demographic health survey weighted sample size 12665 rural women analysed outcome variable assistance delivery dichotomised skilled assistance unskilled assistance explanatory variables selected individuallevel characteristics maternal education parity age first birth religion healthcare decision employment status access mass media means transportation selected communitylevel characteristics community literacy level community childcare burden proportion women employed outside agriculture proportion women perceived distance facility big problem community poverty level geographical region mixedeffects logistic regression appliedduring recent deliveries 230 rural women utilised skilled assistance compared 770 utilised unskilled assistance maternal education parity religion healthcare decision access mass media means transportation individuallevel characteristics revealed significant effects likelihood utilising skilled assistance delivery community literacy level community poverty level community perception distance health facility geographic region communitylevel characteristics revealed significant effects odds using skilled assistance delivery results intraclass correlation icc supported significant communitylevel effects likelihood using skilled assistance deliveryassistance delivery influenced individuallevel communitylevel characteristics health policies programmes seeking reduce ruralurban inequity skilled delivery endeavour identify address important factors individual community levels social environment