The impact of poverty on access to skilled birth attendants in Kaduna State
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Background of the Study
Access to skilled birth attendants (SBAs) is a critical component in reducing maternal and neonatal mortality. In Kaduna State, poverty significantly influences women’s ability to access quality obstetric care. Women living in impoverished conditions often face financial, geographical, and social barriers that limit their access to skilled healthcare during childbirth (Umar, 2023). Poverty restricts resources not only for healthcare but also for transportation and accommodation near health facilities, often forcing expectant mothers to rely on unskilled traditional birth attendants (TBAs) or to give birth at home under unsafe conditions. This scenario is particularly pronounced in remote and underserved communities where economic hardship is compounded by poor infrastructure and limited healthcare services (Ibrahim, 2024).
In Kaduna State, the gap between rich and poor is starkly reflected in maternal health outcomes. Studies have shown that households with lower incomes are less likely to afford quality prenatal care and delivery services, leading to increased risks of complications during childbirth (Bello, 2023). Moreover, the intersection of poverty and low educational attainment often results in reduced awareness of the benefits of skilled birth attendance, further perpetuating the cycle of maternal morbidity and mortality. Socio-cultural factors, such as traditional beliefs and gender roles, may also discourage poor women from seeking institutional deliveries even when services are available (James, 2023).
The current healthcare infrastructure in Kaduna State struggles to meet the demand for skilled obstetric services, particularly in impoverished areas where health facilities are few and far between. Financial constraints, coupled with logistical challenges, exacerbate the difficulty for low-income women to access skilled birth attendants. This study aims to critically examine how poverty influences access to SBAs and to identify the key barriers that prevent expectant mothers from receiving adequate care during childbirth. By integrating quantitative data from health service records and qualitative insights from community interviews, the research seeks to provide a comprehensive understanding of the economic and social determinants that shape maternal health outcomes in Kaduna State.
Statement of the Problem
In Kaduna State, a significant proportion of maternal deaths can be attributed to the lack of access to skilled birth attendants, a situation deeply intertwined with the pervasive poverty in the region. Despite governmental efforts to improve maternal health services, the financial barriers faced by impoverished women continue to hinder their access to quality obstetric care. Many women in low-income households are forced to deliver at home or rely on unskilled traditional birth attendants due to the high costs associated with hospital deliveries, including transportation, service fees, and associated indirect expenses (Umar, 2023). This scenario not only contributes to higher rates of maternal and neonatal complications but also undermines broader public health efforts to reduce mortality rates.
The problem is compounded by the uneven distribution of healthcare facilities, where rural and economically disadvantaged urban areas are underserved. The limited availability of SBAs in these regions means that even when women are willing to seek institutional care, they may be unable to access it due to logistical challenges. Additionally, the low educational levels prevalent among impoverished communities further diminish awareness about the importance of skilled care during childbirth, creating a cycle of neglect and adverse outcomes (Ibrahim, 2024).
Without addressing the root economic causes and systemic inequities, interventions aimed at improving maternal health are likely to have limited success. The lack of comprehensive data on how poverty directly affects access to skilled birth attendants further hampers the development of targeted policies. This study aims to bridge this knowledge gap by systematically investigating the impact of poverty on access to SBAs in Kaduna State. It will explore the multi-dimensional barriers—economic, geographic, and cultural—that contribute to the underutilization of skilled obstetric care, thereby providing a basis for evidence-based policy recommendations (Bello, 2023).
Objectives of the Study
- To evaluate the relationship between household poverty levels and access to skilled birth attendants.
- To identify key economic and infrastructural barriers that prevent poor women from accessing obstetric care.
- To propose policy interventions to improve maternal health outcomes among low-income populations.
Research Questions
- How does poverty affect the likelihood of women accessing skilled birth attendants in Kaduna State?
- What are the main financial and logistical barriers that hinder access to skilled obstetric care?
- Which targeted interventions can effectively improve maternal health service utilization among impoverished women?
Research Hypotheses
- H1: Women from lower-income households are significantly less likely to access skilled birth attendants.
- H2: Financial constraints and poor transportation infrastructure are major determinants of low SBA utilization.
- H3: Community-based support programs can improve access to skilled obstetric care for impoverished women.
Scope and Limitations of the Study
This study focuses on rural and low-income urban communities in Kaduna State. Data will be collected from health facility records, household surveys, and focus group discussions. Limitations include potential underreporting of maternal health data and regional variations in healthcare accessibility.
Definitions of Terms
- Skilled Birth Attendant (SBA): A health professional, such as a midwife, doctor, or nurse, trained to manage normal deliveries and complications.
- Poverty: A condition characterized by insufficient financial resources to meet basic living needs.
- Maternal Health Outcomes: Health indicators related to pregnancy, childbirth, and the postpartum period.
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