Utilization of non-skilled birth attendants in northern Nigeria: a rough terrain to the health-related MDGs.

Non-skilled birth attendants (NSBAs) are likely to deliver low quality maternity care compared with skilled health workers. A total of 6,809 women (15-49 years) were interviewed in a survey of which 5,091 had delivery information. Among women with a last live birth delivered anytime within the five years prior to the survey, 89% had been assisted by NSBAs. Compared to older women (35+), middle-aged women (20-34 years) were 21% more likely to be assisted by NSBAs. For women < or =20 years, the odds of being assisted by NSBAs more than doubled (AOR=2.14) when compared with older women. Residents of Yobe State were 42% more likely to be assisted by NSBA compared with residents of Katsina State. Key interventions should focus on strengthening health services delivery, radio messages and other communication channels to encourage supervised deliveries and intensifying provision of formal education to enable women better understand information given.