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Objective

Determine factors associated with noninstitutional deliveries (NIDs) in urban and rural communities of Ebonyi state, Nigeria.

Methods

Community based cross-sectional comparative study design was used. Two stage sampling technique was used to select 660 women in 4 out of 13 local government areas. Information was obtained using a pre-tested, interviewer administered questionnaire. Respondents were womenwho have delivered in past one year irrespective of place of delivery. Outcome measure was proportion of women who did not deliver with a skilled birth attendant.

Results

Comparable proportion of respondents delivered outside health facilities,(urban, 14.5%; rural, 10%)(p= 0.075). Decisions were made mainly during labour (urban, 43.8%; rural, 36.4%). Predictors of NID in urban areas included receiving no formal antenatal care,(AOR= 50.4; 95% CI: 14.4-177.2), being< 30 years,(AOR= 2.9; 95% CI: 1.1-8.0) and previous history of Caesarean section,(AOR= 0.05, 95% CI: 0.01-0.5). Predictor of NID in rural areas was not receiving formal antenatal care,(AOR= 43.9; 95% CI: 13.0-148.3).

Conclusion

Minor proportion of respondents delivered outside heath facilities in urban and rural communities. Good utilization of primary health centers is essential in improving maternal health in Nigeria especially in rural communities. There is a need for all women to receive antenatal care from skilled providers as this increases the likelihood of delivering with skilled birth attendants. Ensuring deliveries with skilled birth attendants will improve the poor maternal health index in Nigeria.