Olatunde Aremu|Stephen Lawoko|Koustuv Dalal
Neighborhood socioeconomic disadvantage, individual wealth status and patterns of delivery care utilization in Nigeria: a multilevel discrete choice analysis
Karolinska Institutet|University of Ibadan|Karolinska Institutet|Karolinska Institutet|Linköping University
background high maternal mortality continues major public health problem part developing world including nigeria understanding utilization pattern maternal healthcare services accepted important factor reducing maternal deaths study investigates effect neighborhood individual socioeconomic position utilization different forms place delivery among women reproductive age nigeria methods populationbased multilevel discrete choice analysis performed using recent populationbased 2008 nigerian demographic health surveys data women aged 15 49 years analysis restricted 15162 evermarried women 888 communities across 36 states federation including federal capital territory abuja results choice place deliver varies across socioeconomic strata results multilevel discrete choice models indicate every factor controlled household wealth status womens occupation womens partners high level education attainment possession health insurance associated use private government health facilities child birth relative home delivery results also show higher birth order young maternal age associated use home delivery living highly socioeconomic disadvantaged neighborhood associated home birth compared patronage government health facilities specifically result revealed choice facilitybased delivery clustered around neighborhoods conclusion home delivery cuts across socioeconomic strata common practice among women nigeria initiatives would encourage appropriate use healthcare facilities little cost disadvantaged accorded utmost priority keywords delivery care maternal health services utilization multilevel discrete choice nigeria socioeconomic disadvantaged neigborhood health policy