Infants Delivered in Maternity Homes Run by Traditional Birth Attendants in Urban Nigeria: A Community-Based Study

Figures & data

Table 1 Maternal Profile and Place of Delivery in Lagos, Nigeria

	Hospitals	Herbal homes	Family homes
	n = 3,403	n = 2,847	n = 456	Total
Profile	(%)	(%)	(%)	n = 6,706
Age (Years) [a]
<20	88  (38.9)	122  (54.0)	16  (7.1)	226
20–35	2994  (50.3)	2556  (42.9)	406  (6.8)	5956
>35	314  (61.3)	164  (32.0)	34  (6.6)	512
Marital status
Not married	106  (41.9)	137  (54.2)	10  (4.0)	253
Married	3297  (51.1)	2710  (42.0)	446  (6.9)	6453
Ethnicity
Yoruba	2824  (47.1)	2792  (46.5)	383  (6.9)	5999
Hausa	104  (67.1)	18  (11.6)	33  (21.3)	155
Ibo	418  (88.4)	26  (5.5)	29  (6.1)	473
Other	57  (77.2)	11  (13.9)	11  (13.9)	79
Religion
Islam	1906  (41.2)	2407  (52.0)	316  (6.8)	4629
Christianity	1497  (72.2)	440  (21.2)	140  (6.7)	2077
Education
None	71  (36.6)	88  (45.4)	35  (18.0)	194
Primary	358  (34.7)	561  (54.4)	112  (10.9)	1031
Secondary and above	2974  (54.3)	2198  (40.1)	309  (5.6)	5481
Education of spouse
None	34  (49.3)	17  (24.6)	18  (26.1)	69
Primary	76  (36.5)	101  (48.6)	31  (14.9)	208
Secondary and above	3293  (51.2)	2729  (42.4)	407  (6.3)	6429
Occupation
None	574  (62.5)	277  (30.1)	68  (7.4)	919
Small trade/casual job	1911  (43.2)	2179  (49.3)	329  (7.4)	4419
Full-time job	918  (67.1)	391  (28.6)	59  (4.3)	1368
Social class
Low	591  (40.8)	733  (50.6)	125  (8.6)	1449
Middle	2454  (50.5)	2081  (42.8)	322  (6.6)	4857
High	358  (89.5)	33  (8.2)	9  (2.2)	400
Parity [b]
Primiparous	1471  (53.0)	1153  (41.6)	149  (5.4)	2773
Multiparous	1929  (49.1)	1694  (43.1)	307  (7.8)	3930
Antenatal care
Yes	3334  (50.8)	2781  (42.4)	451  (6.9)	6566
None	69  (49.3)	66  (47.1)	5  (3.6)	140
Herbal drug in pregnancy
Yes	1344  (30.6)	2753  (62.7)	295  (6.7)	4392
None	2059  (89.0)	94  (4.1)	161  (7.0)	2314
Multiple pregnancy
No	3323  (50.5)	2811  (42.7)	449  (6.8)	6583
Yes	80  (65.0)	36  (29.3)	7  (5.7)	123
Missing data: [a] = 12 (0.2%); [b] = 3 (0.0%). Herbal homes = traditional maternity homes.

Table 2 Infant Profile and Place of Delivery in Lagos, Nigeria

	Hospitals	Herbal homes	Family homes
	n = 3,403	n = 2,847	n = 456	Total
Profile	(%)	(%)	(%)	n = 6,706
Gender
Female	1617  (50.5)	1383  (43.2)	205  (6.4)	3205
Male	1786  (51.0)	1464  (41.8)	251  (7.2)	3501
Gestation age [a]
Preterm  (<37 weeks)	68  (73.1)	20  (21.5)	5  (5.4)	93
Full-term  (≥ 37 weeks)	3333  (50.5)	2824  (42.7)	449  (6.8)	6606
Underweight [b]
No	2892  (51.1)	2416  (42.7)	348  (6.2)	5656
Yes	400  (47.4)	360  (42.7)	83  (9.8)	843
Stunted [c]
No	1991  (51.8)	1619  (42.1)	234  (6.1)	3844
Yes	879  (51.7)	688  (40.4)	134  (7.9)	1701
Wasted [d]
No	2637  (53.0)	2033  (40.9)	305  (6.1)	4975
Yes	232  (42.3)	256  (46.6)	61  (11.1)	549
Jaundice with phototherapy
No	3166  (49.7)	2786  (43.8)	414  (6.5)	6366
Yes	237  (69.7)	61  (17.9)	42  (12.4)	340
Jaundice with EBT
No	3328  (50.4)	2829  (42.9)	444  (6.7)	6601
Yes	75  (71.4)	18  (17.1)	12  (11.4)	105
Hearing screening outcome
Pass	3162  (50.8)	2640  (42.4)	418  (6.7)	6220
Refer	51  (43.6)	50  (42.7)	16  (13.7)	117
Incomplete	190  (51.5)	157  (42.5)	22  (6.0)	369
Missing data: [a] = 7 (0.1%); [b] = 207 (3.1%); [c] = 1,161 (17.3%); [d] = 1,182 (17.6%).
EBT = exchange blood transfusion; Herbal homes = traditional maternity homes.

Figure 1 Types of birth attendant at place of delivery in Lagos, Nigeria.

Table 3 Maternal Factors Associated With Place of Delivery in Lagos, Nigeria

	Herbal homes	Herbal homes	Family homes
	versus hospital	versus family homes	versus hospital
Profile	OR (95% CI)	OR (95% CI)	OR (95% CI)
Age (Years) [a]
<20	1.88 (1.28–2.78)**	1.31 (0.71–2.42)	1.44 (0.78–2.64)
20–35	1.0	1.0	1.0
>35	0.70 (0.55–0.91)**	0.87 (0.58–1.30)	0.81 (0.55–1.18)
Marital status
Not married	1.0	1.0	1.0
Married	0.92 (0.65–1.30)	0.52 (0.26–1.04)	1.77 (0.88–3.58)
Ethnicity
Yoruba	1.0	1.0	1.0
Hausa	0.49 (0.26–0.94)*	0.26 (0.13–0.53)***	1.87 (1.13–3.10)*
Ibo	0.43 (0.27–0.70)**	0.47 (0.26–0.87)*	0.91 (0.59–1.42)
Other	0.50 (0.23–1.11)	0.41 (0.16–1.05)	1.22 (0.59–2.52)
Religion
Christianity	1.0	1.0	1.0
Islam	1.50 (1.27–1.76)***	1.53 (1.19–1.99)**	0.98 (0.76–1.25)
Education
None	2.24 (1.39–3.61)**	0.83 (0.46–1.47)	2.72 (1.54–4.80)**
Primary	1.67 (1.38–2.02)***	0.75 (0.58–0.98)*	2.23 (1.70–2.92)***
Secondary and above	1.0	1.0	1.0
Education of spouse
None	0.64 (0.29–1.42)	0.40 (0.17–0.96)*	1.60 (0.75–3.42)
Primary	1.04 (0.70–1.56)	0.67 (0.41–1.09)	1.56 (0.96–2.53)
Secondary and above	1.0	1.0	1.0
Occupation
None	1.16 (0.91–1.49)	0.73 (0.48–1.11)	1.58 (1.07–2.34)*
Small trade/casual job	1.51 (1.27–1.79)***	0.87 (0.64–1.19)	1.73 (1.28–2.35)***
Full-time job	1.0	1.0	1.0
Social class
Low	3.57 (2.31–5.52)***	1.29 (0.58–2.88)	2.78 (1.34–5.75)**
Middle	3.72 (2.46–5.62)***	1.35 (0.62–2.93)	2.75 (1.38–5.50)**
High	1.0	1.0	1.0
Parity
Primiparous	0.94 (0.82–1.08)	1.32 (1.05–1.66)*	0.72 (0.57–0.90)**
Multiparous	1.0	1.0	1.0
Antenatal care
Yes	1.0	1.0	1.0
None	0.95 (0.63–1.45)	2.25 (0.88–5.75)	0.42 (0.17–1.08)
Herbal drug in pregnancy
None	1.0	1.0	1.0
Yes	31.13 (24.88–8.95)***	11.35 (8.40–15.34)***	2.74 (2.17–3.46)***
Multiple pregnancy
None	1.0	1.0	1.0
Yes	0.69 (0.42–1.13)	1.08 (0.46–2.53)	0.64 (0.29–1.42)
*p < .05; **p < .01; ***p < .001. Herbal homes = traditional maternity homes. Model adjusted for all covariates.

Table 4 Infant Factors Associated With Place of Delivery in Lagos, Nigeria

	Herbal homes	Herbal homes	Family homes
	versus hospital	versus family homes	versus hospital
Profile	OR (95% CI)	OR (95% CI)	OR (95% CI)
Gestation age	p = .016
Full-term (≥37 weeks)	1.0	1.0	1.0
Preterm (<37 weeks)	0.48 (0.26–0.87)*	0.73 (0.26–2.02)	0.65 (0.25–1.67)
Any undernourishment [a]		p = .002	p < .001
No	1.0	1.0	1.0
Yes	1.03 (0.90–1.18)	0.70 (0.56–0.87)**	1.47 (1.19–1.84)***
Jaundice with phototherapy	p = .027	p < .000	p = .015
No	1.0	1.0	1.0
Yes	0.61 (0.39–0.94)*	0.34 (0.20–0.59)***	1.77 (1.12–2.81)*
Jaundice with EBT
No	1.0	1.0	1.0
Yes	0.69 (0.31–1.54)	0.91 (0.34–2.44)	0.76 (0.33–1.73)
Hearing screening outcome
Pass	1.0	1.0	1.0
Refer	1.09 (0.66–1.78)	0.70 (0.36–1.37)	1.55 (0.79–3.04)
Incomplete	1.13 (0.85–1.50)	1.34 (0.82–2.19)	0.84 (0.52–1.36)
*p < .05; **p < .01; ***p < .001, Missing data: [a] = 204 (3.0%).
EBT = exchange blood transfusion; herbal homes = traditional maternity homes. Model adjusted for all maternal factors with statistical significance (p < .005).