This study examines the determinants of Mission House Delivery among booked patients in Ile-Ife, Nigeria. During the 12 months of the study (1 May 199930 April 2000) 196 booked patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife who delivered at mission houses were analysed. All ages and parity groups, educational level and social classes were involved. The majority (73%) were of low socio-economic class. The reasons for mission house delivery included financial constraints (41%), fear of possible caesarean section (46%), industrial action by health-care workers (39%), transport difficulty at night (26%), previous deliveries in mission houses (16%) and communal feud (12%). Four maternal deaths occurred (MMR 978/100 000 births) and 20 perinatal deaths (PNMR 118/1000 total births). Reduction of hospital user fees, provision of transportation and efficient telecommunication facilities at all times, conflict resolution and proper remuneration of health care workers are urgent needs to be addressed. Legislation against delivery in unsafe places and establishment of appropriate facilities by churches interested in maternity services is highly recommended.
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