title: Spatial analysis of choice of place of delivery in Nigeria.
abstract: OBJECTIVE
  Access to quality healthcare during childbirth is a crucial factor for taming maternal and child mortality and morbidity. Increasing this access in developing countries depends on understanding the factors influencing maternal healthcare decision at a geographical location. This study analyzes spatial pattern in choice of place of delivery in Nigeria.
  
  
  METHODS
  Data analyzed came from Nigerian Demographic and Health Survey data set. The choice of place delivery was considered a multi-categorical response and a multinomial logistic regression model used to evaluate spatial variations in choosing a particular place to deliver against home delivery.
  
  
  RESULTS
  Results show a north-south divide in choosing health facilities against homes for delivery. The likelihood of institutional delivery was significantly lower for women residing in Bayelsa and the majority of the states in northern Nigeria. As women advance in age, they have more likelihood of having institutional deliveries. Other contributing factors that favor institutional deliveries include use of antenatal care services, urban dwelling, mass media and parity.
  
  
  CONCLUSIONS
  Usage of mass media to campaign for institutional deliveries particularly in northern Nigeria, among younger women and those of higher parity; encouraging the use of antenatal services and even distribution of health facilities making them easily accessible to rural women are important for enhancing chances of institutional deliveries. Also, state-specific policies in this regard are indispensable.
authors.affiliation: Department of Mathematical Sciences, Redeemer's University, Redemption City, Nigeria; Center for Regional Development and Planning (CEDEPLAR), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: ezrascribe@yahoo.com.
authors.forename: Ezra
authors.initials: E
authors.lastname: Gayawan
mesh_terms: D001499:Bayes Theorem; D002755:Choice Behavior; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006293:Health Promotion / Q000379:methods; D006297:Health Services Accessibility; D006306:Health Surveys; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008402:Mass Media; D009549:Nigeria; D017711:Nonlinear Dynamics; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000523:psychology / Q000706:statistics & numerical data; D012067:Religion; D012959:Socioeconomic Factors; D062206:Spatial Analysis
keywords: Bayesian; Delivery; Maternal health; Nigeria; Nonlinear effect; Spatial analysis