Aims: To assess the rural-urban differences in the prevalence and factors associated with nonutilization
of healthcare facility for childbirth (home delivery) in Nigeria.
Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by
rural-urban residence was analyzed with appropriate adjustment for the cluster sampling design
of the survey. Factors associated with home delivery were identified using multivariable logistic
regression analysis.
Results: In rural and urban residence, the prevalence of home delivery were 78.3% and
38.1%, respectively (P < 0.001). The lowest prevalence of home delivery occurred in the SouthEast
region for rural residence (18.6%) and the South-West region for urban residence (17.9%).
The North-West region had the highest prevalence of home delivery – 93.6% and 70.5% in rural
and urban residence, respectively. Low maternal as well as paternal education, low antenatal
attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West
and the South-South regions increased the likelihood of home delivery in both rural and urban
residences. Whether in rural or urban residence, birth order of one decreased the likelihood of
home delivery. In rural residence only, living in the North-Central region increased the chances
of home delivery. In urban residence only, maternal age ≥ 36 years decreased the likelihood of
home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it.
Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria
and the associated factors differ to varying degrees in the two residences.