Individual and community-level factors associated with non-institutional delivery of women of childbearing-age in Nigeria

Maternal health remains a major concern in Africa due to high maternal mortality, partly driven by limited access to health facilities and the preference for home-based deliveries assisted by unskilled attendants. In Nigeria, reports indicate that a large share of young women deliver at home, contributing to preventable deaths from poorly managed complications. Using the 2018 Nigeria National Demographic and Health Survey (NDHS) data for 12,567 women of reproductive age who had a birth in the preceding five years, this study examined determinants of non-institutional delivery (home or outside health facilities). A multilevel binary logistic regression estimated adjusted odds ratios (AORs) with 95% confidence intervals. Findings show that 56.8% of women preferred delivering outside health institutions. Women who were educated, lived in urban areas, had media exposure, higher income/wealth, and higher autonomy were less likely to deliver outside health facilities. The study recommends expanding educational opportunities, strengthening advocacy, and leveraging focus group discussions, family outreach, and peer education to increase health-facility delivery during childbirth in Nigeria.