Analysis of the Factors Associated with Utilization of Unskilled Birth Attendants in Nigeria

Abstract

In Nigeria, the issue of unskilled birth attendants (UBAs) is still a major public health concern although there is literature on the benefits of skilled birth attendance in enhancing the health of mothers and their newborns. As such, this research aims at identifying the socio-cultural and economic factors that determine the uptake of UBAs in Nigeria for the period 2019-2024. This review is intended to assess the antecedents of preferring unskilled birth attendants to skilled birth attendants in Nigeria, the consequences and health implications related thereto. An electronic database search was performed using the following databases: PubMed, Google Scholar, Scopus, and African Journals Online, with the following search terms: “unskilled birth attendants,” “maternal health,” and “Nigeria.” Only research articles published between 2019 and 2024 were considered and the analysis focused on socio-cultural, economic and healthcare system factors that determine the use of UBAs. The data were collected and synthesized qualitatively, and the quality of the included studies was evaluated using the CASP checklist. The review finds out that social cultural factors like the cultural belief in TBAs, and the community’s beliefs and practices are factors that enhances the use of UBA. TBAs are preferred by many rural Nigerian women because they are culturally accepted, and because the women believe that TBAs are spiritually supported, more than 60% of rural women in southwestern Nigeria prefer TBAs. Other reasons which the participants mentioned as to why they preferred UBAs included; economic reasons such as cost of skilled birth attendance and costs of transport. This is the reason why women in low-income areas are in a position to open UBAs, because they are cheaper, and can easily access yet health issues may be encountered in the process. The consequence of unskilled birth attendance includes higher incidences of maternal and neonatal mortality, postpartum hemorrhage, infections and birth asphyxia. The factors that stakeholders attribute to the use of unskilled birth attendants in Nigeria are; cultural beliefs in TBAs, influence from the community and the cost of obtaining skilled birth assistance. In order to address these concerns, there is a need to implement strategies to increase access to trained birth attendants, mostly in developing, rural, and low-income settings through enhancing knowledge, outreach and resources. When economics bounds are lowered and cultural practices changing, the use of un trained birth assistants could be minimized and correct maternal and neonatal health could improve in Nigeria.