OBJECTIVES: This study aims to investigate the socio-economic and fetal-maternal characteristics associated with home childbirth in 12 African countries. The findings shed light on the complex interplay of socioeconomic factors and maternal health practices, emphasizing the importance of targeted interventions to promote equitable maternal health outcomes in the continent.

METHODS: A multinational survey approach was employed, utilizing the most recent DHS data from 12 African countries. Socioeconomic indicators such as household wealth, education, occupation, and geographic location were examined using descriptive, bivariate, and multivariate statistical methods. Fetal-maternal characteristics such as maternal age, parity, and antenatal care utilization were also considered in the analysis. The study sought to uncover patterns and relationships between these factors and the decision to have a home birth.

RESULTS: A total of 121,000 weighted and nationally representative samples were analyzed. The choice to give birth at home was significantly correlated with household wealth, according to the socioeconomic analysis (p<0.001). Compared to their counterparts in the higher wealth quintiles, women in the lower wealth quintiles were found to be more likely to choose home childbirth (p<0.001). Furthermore, homebirths with little variation across regions and urban residences had higher rates of maternal and neonatal mortality, and the majority lacked skilled birth assistants than their counterparts with ANC (p<0.05).

CONCLUSIONS: The study serves as a basis for evidence-based policy initiatives that have as their goals of affordable economic enhancement of perinatal healthcare services and the promotion of equitable health outcomes for mothers and newborns throughout the continent.