Choice of birth settings among pregnant women in Nigeria and its association with labour and birth outcome on the mother: a systematic review

The incidence of non-health facility birth in Nigeria has remained persistently high. Many women deliver in non-clinical settings. Scaling up health facility utilisation in Nigeria has remained one of the top priorities for policy makers. Despite an effort to ensure at least 90% of births are attended to by skilled birth attendants, non-facility birth has remained historically high. OBJECTIVE: The purpose of this study is to identify the settings where the birth occurs in Nigeria, analyse the reasons, and evaluate the association between birth setting and maternal outcome following childbirth Method: A mixed-method systematic literature review was conducted. A systematic literature search was conducted across eight databases; ProQuest (Applied Social Science Index and Abstract {ASSIA}), PubMed.gov, CINAHL and MEDLINE (CINAHL and MEDLINE were searched through EbscoHost plus databases), Pub med Central, Embase (OVID), Cochrane library and journal Storage (JSTOR). The search focused on studies relating to the choice of birthplaces, completed in Nigeria and publish in English within the last decade (2011-2021). FINDINGS: A total of 16 articles are included in this review. About 47% and 53 of birth occurred in the health facility and non-health facilities, respectively. Nearly all health facility birth occurred in General hospitals. Evidence suggests that the non-health facility setting feels like home, with Traditional birth attendants, and in a faith-based setting. About 15% of the home birth were attended to by Skilled Birth Attendants. Three major themes with a few specific subthemes emerged on the reasons for birthplace preference. They are individuals, the healthcare system, and the social economic factors. The analysis of birthplace and maternal outcome suggests a significant correlation between informal birth settings and obstetric complications CONCLUSIONS: There is a need to address the significant regional variation in the choice of birthplaces. Providing maternity care that is women and family cantered, socially, culturally, religiously appropriate, and regionally suitable will ensure the provision of excellent and equitable through for all mothers in the communities and health care settings. Recommendation: There is a need to engage members of the local communities in disseminating research findings, designing an intervention, and promoting health programs to increase participation. For healthcare providers, there is a need for support and training in value-based patient care.