Online Program

Behavioral risk patterns among women who deliver themselves with no one present in Northwestern Nigeria

Monday, November 2, 2015 : 8:30 a.m. - 8:43 a.m.

Bolaji Fapohunda, PhD., International Health /Maternal, newborn and Child Health/Women's health, Independent Consultant, Germantown,MD, MD
Nosakhare Orobaton, DrPH, MBA, International Health, John Snow, Inc, Rosslyn, VA
Kamil Shoretire, MD, TSHIP, Bauchi, Nigeria
Goli Lamiri, MBBS, DTM&H, MPH, Targeted States High Impact Project, Sokoto, Nigeria


This paper examines the concentration of health care risks in women who deliver their children alone, with no one present (NOP); this is the tendency women to exhibit other hazardous MNCH care characteristics. 


Data were from 5619 currently married women, 15-49 years, surveyed in 2013 NDHS. The outcome measure was dummy coded 1 if women delivered their last births with NOP versussome assistance. Health seeking behavior across the continuum of care was measured with seven elements: contraceptive use, ANC attendance, PNC checkup following delivery, exclusive breastfeeding, appropriate child feeding, ITN ownership, and home management of diarrhea. Data were analyzed using bivariate and logistic regression approaches. 


The logistic regression revealed that, compared with women who delivered with any assistance, those who delivered with NOP were 44% less likely to use contraception, 15% less likely to seek ANC, 364% less likely to be checked medically following delivery, 55% less likely to breastfeed infant within their 1sthour of life, 32% more likely to feed foods/liquids other than breast milk in 1st three days of the infant’s life, 20% less likely to have acquired a health card for their U5,  68% more likely to report a diarrheal disease in two weeks prior to the survey and 128% less likely to have presented the children for antibiotics. These effects remained statistically significant after controlling for socioeconomic and normative contexts of women’s lives


Given the concentration of risk in these women, significant leadership is required from government to address the problem and an integrated program would likely be helpful.

Learning Areas:

Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Program planning
Social and behavioral sciences

Learning Objectives:
Describe the profile of women who deliver with NOP vis a vis those who delver with skilled or any assistance Evaluate the integration of risky behavior among the two groups of women, that is the tendency to use inappropriate health care approaches Discuss implications for policy and actions for improving health seeking behaviors across the continuum of care among women in resource poor settings

Keyword(s): Maternal and Child Health, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Public Health Professional, specializing in Monitoring and evaluation of public health interventions; over 12 Years of experience supporting Projects & research in resource poor Countries. Bolaji Fapohunda has worked subtantially on maternal, newborn and child health topics, particularly performance result M&E of programs in these technical areas. More recently, her work has focused on delivery health, explicating the phenomenon of women delivering their children, all alone, by themselves with no one present in sub-Saharan Africa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.