ArticleBMJ open2022
Multivariate decomposition of trends, inequalities and predictors of skilled birth attendants utilisation in Nigeria (1990-2018): a cross-sectional analysis of change drivers.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Article
- Trend and social determinants of non-facility births in Northwestern Nigeria: pooled analysis of demographic and health survey 2003-2018.BMC public health · 2026Article
- Spatial variation and hierarchical analysis of institutional delivery dropout after antenatal care contacts in Nigeria: findings from 3-survey rounds.Scientific reports · 2026Article
- Article
- Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.Maternal and child health journal · 2025Article
- Global dominance of non-institutional delivery and the risky impact on maternal mortality spike in 25 Sub-Saharan African Countries.Global health research and policy · 2025Article
- Trend and decomposition analysis of factors influencing teenage pregnancy and motherhood in Nigeria, 2003-2018.PloS one · 2025Article
- Rural‒urban disparities in household catastrophic health expenditure in Bangladesh: a multivariate decomposition analysis.International journal for equity in health · 2024Article
- Multilevel and subnational analysis of the predictors of maternity continuum of care completion in Nigeria: a cross-sectional survey.Scientific reports · 2023Article
- Correlates of non-institutional delivery to delayed initiation of breastfeeding in Nigeria: logit-decomposition and subnational analysis of population-based survey.Journal of health, population, and nutrition · 2023Article
- Article
- Disparities and barriers of health facility delivery following optimal and suboptimal pregnancy care in Nigeria: evidence of home births from cross-sectional surveys.BMC women's health · 2023Article
- Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming.BMC pregnancy and childbirth · 2023Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLiterature has assessed skilled birth attendants (SBAs) utilisation, but little is known about what contributes to the changes in SBA use. Multivariate decomposition analysis was thus applied in this study to examine; levels, trends, inequalities and drivers of changes in SBA utilisation. DESIGN AND
settingA cross-sectional analysis of five-waves of NDHS-data (1990, 2003, 2008, 2013, and 2018), collected through similar multistage sampling across the 36 states and the federal-capital-territory of Nigeria.
participantsWomen of reproductive age (15-49 years), and with at least one birth in the last 5 years preceding each of the surveys.
main outcome measureSBA use is the response variable while explanatory variables were classified into; Demographics, Health, Economic and Corporal factors.
methodsChi-square test for trends of proportions across the ordered survey years assessed trends in SBA use. MDA that quantifies and partition predictors effect into endowment and coefficient components evaluated contributors to changes in SBA use. Statistical analysis was carried out at a 95% confidence interval in Stata 16.
resultsSBA use increased with significant (p<0.05) linear trends by 12% between 2003 and 2018. The decomposition analysis showed that differences in characteristics (endowment) accounted for 11.5% of the changes while the remaining 88.5% were due to differences in effects (coefficient). SBA utilisation rises by 61% when respondents decided on her health compared to when such decisions were made by the spouse. Utilisation of SBA, however, fell by 88% among women who reside in the states with high rural populations percentage.
conclusionsSBA use remained low in Nigeria, and slowly increase at the rate of <1% yearly. Women health decision-making power contributed most to positive changes. Residing in states with high rural populations has a negative impact on SBA use. Maternal health programmes that strengthen women's health autonomy and capacity building in rural communities should be encouraged.
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