1.1 Introduction
Hospital-based delivery is defined as childbirth that takes place in a health facility under the supervision of skilled birth attendants such as doctors, nurses, or midwives, who are equipped with the necessary knowledge and resources to manage normal deliveries and respond effectively to complications (World Health Organization, 2023). It represents a key component of maternal healthcare aimed at reducing maternal and neonatal morbidity and mortality through safe delivery practices and timely medical intervention. Knowledge of hospital-based delivery among women of childbearing age refers to the extent of awareness, understanding, and information women possess regarding the benefits, availability, and importance of delivering in a health facility rather than at home or in non-clinical settings.
In many developing countries, particularly in sub-Saharan Africa, maternal health outcomes remain a significant public health concern due to limited utilization of skilled birth services. In Nigeria, despite improvements in healthcare delivery systems, a considerable proportion of women still deliver outside health facilities, often due to inadequate knowledge, cultural beliefs, and misconceptions about childbirth practices (National Population Commission [NPC] & ICF, 2019).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Hospital-based delivery refers to childbirth conducted within a health facility under the supervision of skilled health professionals such as doctors, nurses, and midwives who are trained to manage normal labor and respond promptly to obstetric complications. According to the World Health Organization (WHO, 2023), skilled attendance at birth is one of the most effective strategies for reducing maternal and neonatal mortality globally. Knowledge of hospital-based delivery among women of childbearing age refers to the level of awareness, understanding, and information women possess regarding the importance, benefits, and availability of delivering in a health facility rather than at home or with untrained traditional birth attendants.
According to WHO (2023), maternal mortality remains unacceptably high in many developing regions, particularly sub-Saharan Africa, where access to skilled birth attendants and health facilities is still limited. The organization reported that most maternal deaths are preventable when childbirth occurs in adequately equipped health facilities. It further emphasized that increasing women's knowledge of safe delivery practices is central to improving maternal health outcomes.
In Nigeria, maternal health challenges persist despite various government interventions and international support. The National Population Commission (NPC) and ICF (2019) reported that a significant proportion of women still deliver at home without skilled assistance. They asserted that low utilization of hospital-based delivery services is linked to inadequate knowledge, socio-cultural beliefs, and limited access to quality maternal health education. These factors contribute to preventable complications such as hemorrhage, sepsis, and obstructed labor, which are major causes of maternal deaths in the country.
UNICEF (2022) stated that many women in rural and semi-urban communities still lack sufficient information about the benefits of skilled birth attendance. The organization affirmed that improving maternal health literacy is essential for increasing facility-based deliveries and reducing neonatal deaths. According to Okonofua et al. (2018), knowledge plays a critical role in determining maternal health-seeking behavior. They reported that women who possess adequate knowledge of pregnancy complications and the benefits of hospital delivery are more likely to utilize health facilities during childbirth. However, they contended that knowledge alone may not always translate into practice due to other influencing factors such as cost, distance, and perceived quality of care (Okonofua et al., 2018).
Similarly, Campbell and Graham (2019) stated that improving maternal outcomes requires not only access to health facilities but also increased awareness and education at the community level. They affirmed that skilled birth attendance reduces both maternal and neonatal mortality significantly when utilized appropriately. They further emphasized that antenatal care visits should serve as a key platform for educating women on the importance of hospital-based delivery. In many parts of Nigeria, cultural beliefs and traditional norms continue to influence childbirth practices. According to Aremu et al. (2020), some women still believe that childbirth is a natural process that does not require medical intervention unless complications arise. They reported that such beliefs reduce the perceived need for hospital-based delivery, especially among women with low educational attainment. This study is set against the backdrop of improving maternal health outcomes through enhanced knowledge and utilization of hospital-based delivery services among women of childbearing age.
1.3 Statement of Problems
In Nigeria, maternal mortality remains a persistent challenge, with many deaths linked to complications during pregnancy and childbirth that are preventable when deliveries occur in well-equipped health facilities. Studies have shown that gaps in knowledge about danger signs in pregnancy, benefits of antenatal care, and availability of emergency obstetric services contribute significantly to poor delivery choices among women (NPC & ICF, 2019). Many women are still influenced by cultural beliefs, family pressure, and misconceptions that hospital-based delivery is only necessary for complicated pregnancies, rather than for all births.
On the other hand, even when women are aware of hospital-based delivery services, accessibility challenges such as distance to health facilities, cost of services, and perceived unfriendly attitudes of healthcare workers affect their willingness to utilize such services. In some cases, women is exposed to misinformation within their social networks that discourages them from seeking skilled birth attendance.
Furthermore, inadequate health education during antenatal care visits limits the depth of understanding women is expected to have regarding safe delivery practices. When health information is not effectively communicated, women is likely to rely on traditional practices that may not ensure safe delivery outcomes. It is against this backdrop that this study seeks to assess the knowledge of hospital-based delivery among women of childbearing age.
1.4 Aim and Objectives of Study
The aim of this study is to assess the knowledge of hospital-based delivery among women of childbearing age. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the level of knowledge women have about hospital-based delivery.
- To identify sources of information on hospital-based delivery among women.
- To determine factors influencing women's knowledge of hospital-based delivery.
- To assess the relationship between knowledge and utilization of hospital-based delivery services.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge of hospital-based delivery among women of childbearing age?
- What are the sources of information on hospital-based delivery among women?
- What factors influence women's knowledge of hospital-based delivery?
- What is the relationship between knowledge and utilization of hospital-based delivery services?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H0: There is no significant relationship between women's knowledge of hospital-based delivery and their utilization of hospital-based delivery services.
- H1: There is a significant relationship between women's knowledge of hospital-based delivery and their utilization of hospital-based delivery services.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will assist university management in developing structured awareness programs that will promote positive student behavior and reduce cult-related activities. The study will also assist community health workers in developing more focused outreach programs that will encourage early and consistent use of health facilities for childbirth.
Furthermore, the study will support non-governmental organizations in implementing community-based health awareness campaigns focused on safe delivery practices. In addition, the study will help healthcare providers in designing targeted antenatal education programs that will improve maternal health knowledge.
Lastly, the study will guide security agencies and institutional stakeholders in improving communication frameworks that will enhance early detection and prevention of cultism-related incidents.
1.8 Scope of Study
The scope of the research is focused on assessing the knowledge of hospital-based delivery among women of childbearing age in Lagos State Primary Health Care Centres under the Lagos State Primary Health Care Board.
1.9 Limitations of the Study
The study was limited by geographical coverage as it was restricted to selected health facilities in Lagos State, which was not fully representative of all women of childbearing age in Nigeria. It was also limited by respondent bias as some participants was not willing to provide complete information during data collection.
1.10 Definition of Terms
Knowledge:
Knowledge refers to the level of awareness, understanding, and information an individual possesses about a particular subject or practice. In this study, it refers to women's understanding of hospital-based delivery and its benefits (UNICEF, 2022).
Women of Childbearing Age:
Women of childbearing age refers to females within the reproductive age group of 15–49 years who is biologically capable of becoming pregnant and giving birth (NPC & ICF, 2019).
Hospital-Based Delivery:
Hospital-based delivery is defined as childbirth that takes place in a health facility under the supervision of skilled health personnel such as doctors, nurses, and midwives who is trained to manage normal and complicated deliveries (World Health Organization, 2023). It is considered a safe maternal health practice aimed at reducing maternal and neonatal mortality.
Skilled Birth Attendant:
Skilled birth attendant refers to an accredited health professional such as a midwife or doctor who is trained to manage normal pregnancies, childbirth, and the immediate postnatal period (WHO, 2023).
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