Factors Associated with Poor Utilization of Hospital Delivery Services among Women of Childbearing Age in Birnin Ruwa, Zamfara State, Nigeria

Abstract

Background: Maternal mortality remains unacceptably high in sub-Saharan Africa, with Nigeria contributing significantly to the global burden. Despite the availability of healthcare facilities, poor utilization of hospital delivery services persists among rural women. This study assessed factors responsible for poor utilization of hospital delivery services, in Birnin Ruwa, Gusau, Zamfara State. Methods: A descriptive cross-sectional research design was adopted. A sample of 171 women of childbearing age (15–49 years) who had given birth at least once was selected using Multi stage sampling. Data were collected using a structured questionnaire and analyzed using SPSS version 25. Descriptive statistics including frequencies, percentages, and mean scores were computed. Results: The findings revealed that only 29.2% of respondents utilized hospital delivery services, while 46.8% previously delivered at home. Major factors identified included high cost of delivery services (mean=3.93), preference for Traditional Birth Attendants (mean=3.80), transportation difficulties (mean=3.77), long distance to health facilities (mean=3.75), lack of adequate hospital equipment (mean=3.68), lack of privacy (mean=3.67), limited availability of female healthcare workers (mean=3.66), past negative experiences (mean=3.59), and negative attitudes of healthcare workers (mean=3.57). Despite these barriers, respondents demonstrated positive perceptions of hospital delivery, acknowledging it as safer (mean=4.11) and complication-preventive (mean=4.07). Key strategies identified included reducing delivery costs (mean=4.29), free/subsidized maternity services (mean=4.27), improving healthcare worker attitudes (mean=4.26), strengthening facility equipment (mean=4.25), community health education (mean=4.24), and improving transportation (mean=4.20). Conclusion: Poor utilization of hospital delivery services is influenced by economic, cultural, and health system-related factors. Multifaceted interventions addressing financial barriers, cultural sensitivities, and healthcare quality are urgently needed.