‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

• DOI: 10.21106/ijma.632
• Publication Date: 2023-05-08T21:44:09Z
• Authors: Zubairu Iliyasu; Amina A. Umar; Fatima S. Gaya; Nafisa S. Nass; Hadiza M. Abdullahi; Aminatu A. Kwaku; Taiwo G. Amole; Fatimah I. Tsiga-...; Hadiza S. Galadanci; Hamisu M. Salihu; Muktar H. Aliyu
• Keywords: Overcrowding; Pandemic

The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal services. disruptive effects on the utilization of services in low-resource settings, Nigeria have not been well documented. We assessed service utilization, predictors, and childbirth experiences amidst restrictions a rural community Kumbotso, Kano State, northern Nigeria.Using an explanatory mixed methods design, 389 mothers were surveyed January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with sub-sample (n=20). Data analyzed logistic regression models framework approach.Less than one-half (n=165, 42.4%) women utilized during period compared nearly two-thirds (n=237, 65.8%) prior to (p<0.05). Non-utilization was mainly due fear contracting (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), harassment security personnel (n=24, 10.7%). associated participant's post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), employment type (civil service, aOR=4.60, CI: 1.17-19.74) (p<0.001), business aOR=1.94, CI:1.19- 4.12) (p=0.032) trading aOR=1.62, CI:1.19-2.94) (p=0.04)). Women higher household monthly income (≥ N30,000, equivalent 60 US Dollars) (aOR=1.53, CI:1.13-2.65) (p=0.037), who adhered preventive measures before more likely utilize those restrictions. In contrast, parity (≥5 births) less use lockdown (aOR=0.30, CI:0.10-0.86) (p=0.03). Utilization also partner type.The declined hindered COVID-19, transport challenges, personnel. Maternal characteristics, adherence measures, pre-COVID maternity influenced attendance. There is need build resilient systems contingent alternative delivery for future pandemics.