Abstract
BACKGROUND AND AIMS: Maternal health outcomes in Nigeria remain a critical concern, with the country contributing to nearly 20% of global maternal deaths. Health facility delivery, a key intervention to reduce maternal and neonatal mortality, is underutilized, with only 43.1% of women delivering to health facilities. This study examined the prevalence, regional disparities, and sociodemographic determinants of health facility delivery among women in Nigeria using data from the 2018 Nigeria Demographic and Health Survey (NDHS). METHODS: The study analyzed data from the 2018 NDHS, consisting of 21,442 women aged 15-49 years who reported their place of delivery for their most recent birth. Descriptive statistics were used to assess the prevalence of health facility deliveries, and regional disparities were visualized using charts and maps. Bivariate and multivariable logistic regression models were applied to identify the sociodemographic factors associated with health facility delivery, including education, wealth, residence, and geographic region. RESULTS: The prevalence of health facility deliveries was 43.1%; regional disparities (differences) were found in the observed prevalence. The South East and South West regions reported the highest rates (81.58% and 81.59%, respectively), while the North West and North East had the lowest (16.37% and 26.72%, respectively). Women with higher education (AOR: 6.55, 95% CI: 5.15-8.34) and those in the richest quintile (AOR: 5.92, 95% CI: 4.65-7.54) were significantly more likely to deliver in health facilities. Rural residence and distance to health facilities were associated with lower odds of delivery. CONCLUSION: Sociodemographic, economic, and geographic factors strongly influence health facility delivery in Nigeria. Targeted interventions addressing educational, economic, and infrastructural barriers are essential to improve facility-based deliveries and reduce maternal mortality in Nigeria.