title: Orthodox versus unorthodox care: A qualitative study on where rural women seek healthcare during pregnancy and childbirth in Southwest, Nigeria.
abstract: BACKGROUND
  Utilization of orthodox health facilities for maternal health services is determined by factors operating at the individual, household, community and state level. The prevalence of small family norm is one of the identified variables operating within the community which influences the decision of where to access care (orthodox/traditional). The objective of the study was to determine the use of orthodox versus unorthodox maternity healthcare and determinants among rural women in southwest Nigeria.
  
  
  METHODS
  A qualitative study was done and involved three focus group discussions. A semi-structured interview guide was used to collect information from women of reproductive age group within a rural Local Government Area in Lagos state.
  
  
  RESULTS
  Most of the women access some form of healthcare during pregnancy, orthodox, unorthodox or both. Those who patronize both services concurrently do so to benefit from the two as each has some unique features such as herbal concoctions for traditional, ultrasound and immunization of babies for orthodox. Traditional belief exerts a strong influence on decision of where to access maternal healthcare services. Actual place of delivery is determined by individual and household factors including financial resources.
  
  
  CONCLUSIONS
  Rural women utilize one or both orthodox and unorthodox maternal health services for different reasons. Ward Development Committees should be strengthened so as to reach the communities, educate and convince women to dispel myths which limit their use of orthodox care. Training and monitoring of Traditional Birth Attendants (TBAs) are vital to eliminate harmful practices. We also recommend improved financial access to orthodox healthcare.
authors.affiliation: Department of Community Health & Primary care, College of Medicine University of Lagos Nigeria.
authors.forename: I P
authors.initials: IP
authors.lastname: Okafor
authors.affiliation: Department of Community Health & Primary care, College of Medicine University of Lagos Nigeria.
authors.forename: A O
authors.initials: AO
authors.lastname: Sekoni
authors.affiliation: Department of Community Health & Primary care, College of Medicine University of Lagos Nigeria.
authors.forename: S S
authors.initials: SS
authors.lastname: Ezeiru
authors.affiliation: Department of Obstetrics & Gynaecology, Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: J O
authors.initials: JO
authors.lastname: Ugboaja
authors.affiliation: Department of Community Health & Primary care, College of Medicine University of Lagos Nigeria.
authors.forename: V
authors.initials: V
authors.lastname: Inem
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008880:Midwifery; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D036301:Qualitative Research; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult