Underutilization of formal maternal care services and accredited health attendants is a major contributor to the high maternal mortality rates in rural communities in Nigeria. Perceptions of a poor quality of care and inaccessible services in health facilities strongly influence the low use of formal maternal care services.  

​A qualitative study of community elders' perceptions about the underutilization of formal maternal care and maternal death in rural Nigeria - PubMed (nih.gov)