Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study

Olusanya, Bolajoko O.; Roberts, Alero A.; Olufunlayo, Tolulope F.; Inem, Victor A.

doi:10.1016/j.healthpol.2010.02.002

« Previous Next »Health Policy
Volume 96, Issue 3 , Pages 210-216, August 2010

Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study

Bolajoko O. Olusanya
- Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
- Institute of Child Health & Great Ormond Street Hospital for Children NHS Trust, University College London, 30 Guilford Street, London WC1N 1EH, UK
- Corresponding author at: Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. Tel.: +234 1 7746999/803 33 44 300.
Alero A. Roberts
- Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
- Tel.: +234 703 270 3988/803 308 3071.
Tolulope F. Olufunlayo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
- Tel.: +234 802 321 8162/1 8739804.
Victor A. Inem
- Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
- Tel.: +234 802 223 5673.

published online 02 March 2010.

Abstract

Objectives

To determine factors associated with maternal preference for delivery in private hospitals in an urban community in sub-Saharan Africa.

Methods

A cross-sectional study of socio-demographic and obstetric characteristics of mothers and their newborns attending Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos, Nigeria. Factors associated with delivery in private hospitals were determined using multivariable logistic regression analyses.

Results

Of the 3296 mothers enlisted for this study 1659 (50.3%) delivered in private hospitals and 1637 (49.7%) in public hospitals. Government hospitals had a higher proportion of doctors at delivery. Use of private obstetric services was significantly associated with ethnicity, religion, social class and obstetric history. Infants delivered at private hospitals were significantly more likely to be undernourished and have severe hyperbilirubinemia but less likely to be preterm and at no greater risk of hearing loss.

Conclusions

Current global strategies to expand facility-based deliveries in order to reduce maternal and child mortality rates need to be complemented by improved regulatory/supervisory framework at country levels to better serve mothers and their offspring in urban areas who may opt for private hospitals usually lacking adequate obstetric and pediatric facilities against the backdrop of the rapid urban transition in Africa.

Keywords: Maternal health, Urban health, Health-seeking behavior, Immunization clinics, Developing country