# Determinants of Skilled Birth Attendance in Nigeria
### A Population-Based Analysis Using DHS 2018 Data
DOI: 10.64898/2026.04.23.26350432
---
## 📋 **Table of Contents**
- Overview
- Key Findings
- Background & Motivation
- Research Questions
- Data
- Methods
- Results
- Visualizations
- Limitations
- References
- Contact
- Acknowledgments
---
## 🎯 **Overview**
This project analyzes **21,465 births** from the **2018 Nigeria Demographic and Health Survey (NDHS)** to identify independent predictors of skilled birth attendance using **multivariable logistic regression** with proper confounding adjustment.
**Why This Matters:**
Nigeria accounted for approximately 20% of global maternal deaths in 2017 (WHO, 2019). While recent estimates suggest modest progress (WHO, 2023), the country remains among the world's highest-burden settings for maternal mortality. This 2018 analysis remains highly relevant for understanding structural barriers to skilled delivery care and informing targeted interventions.Understanding barriers to skilled delivery care is critical for reducing preventable maternal mortality. This analysis provides evidence-based insights for policy intervention.
**Key Contribution:**
Unlike descriptive reports, this analysis **controls for confounding** to isolate independent effects, revealing which factors truly drive access to skilled care versus which associations are explained by other variables.
---
## 🔑 **Key Findings**
| Finding | Statistic | Interpretation |
|---------|-----------|----------------|
| **Overall SBA prevalence** | **44.9%** | Only 4 in 9 Nigerian women deliver with skilled care |
| **Strongest predictor** | Higher education: **aOR = 7.01** (95% CI: 5.68–8.67) | 7× the odds vs no education, after adjustment |
| **Most actionable factor** | ANC ≥4 visits: **aOR = 3.80** (95% CI: 3.51–4.11) | Nearly 4× the odds; modifiable through programs |
| **Wealth gradient** | Richest vs Poorest: **aOR = 6.27** (95% CI: 5.27–7.46) | …