In a three days stakeholders meeting on Nigeria Research Days for Maternal New born and Child Health (MNCH) conference held in Abuja from July 11 -13, 2018 at Rock View Hotel, Professor Friday, Okonofua gave a presentation on “Increasing Women's Access to Skilled Pregnancy Care in Nigeria: Results achieved’’. In his Lecture, he stated that according to WHO 2015, Nigeria accounts for 19% of global Maternal Mortality. The major reason for these deaths is that many women particularly those in rural areas do not attend primary health centres for antenatal care, during delivery and post-natal care.
Although the Nigeria government has made maternal and child health a priority, the Women’s Health Action and Research Centre (WHARC) a non-profitable organization in Collaboration with International Development Research Centre, Canada is currently working on Increasing Women's Access to Skilled Pregnancy Care to Reduce Maternal and Perinatal Mortality in Rural Nigeria. This is with a view to strengthening the availability and access to maternal primary health care services in two local government areas (Esan South East and Etsako East) in Edo State.
In the formative research plan, among the 1,314 pregnant study participant, the results of the baseline study on place of delivery showed that 46.6% of these women gave birth in a PHC while 24.8% gave birth at home or with a traditional birth attendant (fig 1).
More so, the findings from this study also revealed that women with higher education are less likely to use a PHC. With regards religious background, Muslim women are more likely to use a PHC than Christians and women with less autonomy are more likely to use a PHC. The results of the project also revealed that the major barriers to utilization of primary health care services in these rural communities were:
- Poor accessibility to Primary Health Care (PHC)
- Poor quality of health care
- Cost of services
- PHC environment/facilities
In order to address these barriers, WHARC intervention activities included
- Signing an MOU with Taxi drivers association for transporting pregnant women in cases of emergency, use of rapid SMS and linkage of PHCs to referral Hospitals.
- Advocacy services which include: more staffing of PHCs, retraining and retooling PHCs staff, supplying of hospital consumables and use of drug revolving fund.
- Introduction of community health insurance (‘‘esusu’’) which involves monthly contribution of N100 per family and donations by WHARC to the scheme
- Provision of equipment and repairs as well as renovation of PHCs through Ward Development Committee.
- Regular community health talk
In conclusion, it is apparent that the community ownership model can succeed in rural communities through strategic community engagement using ward development committees to encourage the use of PHCs by women for skilled pregnancy care.
Fig 1: Profile of Birthing Facilities among Study Population
- Predictors of Women’s Utilization of Primary Health Care for Skilled Pregnancy Care in Rural Nigeria. BMC Pregnancy and Childbirth (2018) 18:106 https://doi.org/10.1186/s12884-018-1730-4
- Increasing women’s access to skilled pregnancy care to reduce maternal and perinatal mortality in rural Edo State, Nigeria: a randomized controlled trial. Global Health Research and Policy (2018) 3:12 https://doi.org/10.1186/s41256-018-0066-y
Submitted for Publication
- Gender inequality as barrier to women’s access to skilled pregnancy care in rural Nigeria: A qualitative study. Frontiers in Public Health
- A qualitative study of non-utilisation of skilled pregnancy care in rural Nigeria. Women and Birth.
- Men’s Perception of Barriers to Women’s Use and Access of Skilled Pregnancy Care In Rural Nigeria: A Qualitative Study.
Accepted Conference Abstracts
- Building community-led interventions for demand creation for skilled pregnancy care in rural Nigeria. 5th Global Symposium on Health Systems Research, Liverpool, UK. Abstract ID: 1537. Accepted.
- Why women do not use Primary Health Centres for skilled pregnancy care in rural Nigeria: Evidence from a mixed method study 5th Global Symposium on Health Systems Research, Liverpool, UK. Abstract ID: 1541
- “I don’t think family planning is helping women rather it is “killing” many women”: Uncovering persistent ignorance and misconceptions about family planning in rural Nigeria. International Conference on Family Planning. International Conference on Family Planning, Kigali Rwanda. Abstract (ID 1166) Accepted.