Seasonal Patterns of Facility-Based Deliveries in Vital Registration System: Evidence from Kogi State, North-central Nigeria

Despite the massive investment in maternal care over the last three decades, Nigeria still has the highest home deliveries in sub-Saharan Africa. This study utilized live birth and socio-economic data compiled in 2018 by the National Population Commission (NPC), Nigeria to understand seasonal patterns of births in Lokoja, North-central Nigeria. The monthly reported health data was collected from 12,589 reproductive aged women in 13 health facilities for five years (2014 -2018). Analysis of Variance was employed to examine significant variations in birth seasonality, while student’s t-test was used to compare birth rate in urban and rural areas. The results showed that a total of 38,696 live births was recorded from 2014 – 2018. Majority (90.75%) of the reproductive aged women was 20-39years, 70 percent of whom were educated with at least primary education, and 84.2 percent gave birth in the hospital. There was no significant statistical difference in male and female births (t = 0.271, p>0.05). The highest births were recorded in December, July, and August (47.48%), while the lowest births occurred in March and February (9.67%). Conception was higher in April (22.5%) and lower in July (4.66%). Urban areas recorded more deliveries in the hospitals. There was a significant upward pattern in live births from 2014 to 2018, with 29.6 percent increase. It is recommended that sexual and reproductive health related interventions should focus more on the influence of socio-economic and seasonal barriers. This is to enable reproductive women better able to plan their pregnancies to control fertility rate. These findings highlight the fact that data on monthly deliveries can be used to infer seasonally related births and conception and so suggest the potential benefit of focused and heightened efforts to prevent unintended pregnancies and unplanned births. Findings on season of high conception may influence sexual behaviour. Married or sexually active individuals may choose to avoid pregnancy or sexual activity during risky times of the year because of the likelihood of conception. This may also inform contraceptive use and negotiated sexual relations among sexual partners. Sexual health promotion campaigns and safer pregnancy related interventions; most notably contraceptive use advocacy should be targeted at young mothers at the onset of the rainy season. There should be more investment in family planning to address the unmet needs of women in the study area and encourage female secondary education to be better able to control fertility and develop a workforce to maximize demographic dividends and contribute to climate change adaptation. Aspects of seasonal influences on fertility should be incorporated into family planning as well as sexual and reproductive health information to enable women understand the health risks and benefits associated with reproduction in particular seasons to guarantee adequate timing of pregnancies towards seasons most preferred in order to achieve fertility. It is noteworthy that awareness of seasonal effects on conception and births has serious implications on maternal care provision and uptake. Efforts should be geared towards creating easier access to health care and counseling services as delay in seeking preventive services may reflect influence of seasonal barriers. Health education should focus more on risky seasons and safer periods to avoid the risk of unintended pregnancy and unplanned birth. Finally, the findings of this study point to the importance of considering seasonal effects on birth control programmes and further