Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study.
OBJECTIVE
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.
Olusanya
Bolajoko O
BO
Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. tosisanya@yahoo.com
Roberts
Alero A
AA
Olufunlayo
Tolulope F
TF
Inem
Victor A
VA
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D016304:Hospitals, Private; D006786:Hospitals, Urban; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000706:statistics & numerical data; D016389:Maternal-Child Nursing; D009549:Nigeria; D019370:Observation; D010342:Patient Acceptance of Health Care; D057240:Patient Preference / Q000706:statistics & numerical data*; D011247:Pregnancy; D055815:Young Adult