PROVISION, UTILIZATION, AND ENHANCEMENT STRATEGIES OF MATERNAL HEALTH SERVICES IN ENUGU STATE

 PROVISION, UTILIZATION, AND ENHANCEMENT STRATEGIES OF MATERNAL HEALTH SERVICES IN ENUGU STATE

ABSTRACT

The purpose of the study was to determine the Provision, Utilization, and Enhancement Strategies of Maternal Health Services in Enugu State. Fourteen specific objectives and corresponding research questions were posed to guide the study while five hypotheses were postulated and tested at .05 level of significance. The population for the study consisted of one hundred and seventy nine thousand and six (179,006) respondents. The sample for the study consisted of two thousand nine hundred and fifty nine (2,959). Four instruments were used for data collection: two questionnaires one for staff and one for pregnant women, MHS Key Informant Interview Schedule (MHSKIIS), and MHS Focus Group Discussion Guilde (MHSFGDG). Questionnaire on MHS Provision (QMHSP) and MHS Utilization Questionnaire (MHSUQ). QMHSP elicited quantitative information on provision of MHS while MHSUQ elicited quantitative information on utilization of MHS and enhancement strategies from the women of child bearing age. The MHSKIIS and MHSFGDG elicited qualitative information on provision, utilization and enhancement strategies. The Crombach Alpha Statistics and Kudder-Richardson formula were used for testing the reliability. The reliability index were section B= .93, .97,

.78 and .94; for MHSUQ were section B= .62, .64, and .89. Results of the study showed that: antenatal care services (=2.85) and post-natal services (=2.99) were moderately provided while delivery care services (=3.68) were provided to a high extent. Drugs and equipment (=2.60) were moderately provided. ACS services were utilized to a high extent (=3.63). Delivery care services were utilized to a moderate extent. Postnatal care services were utilized to a high proportion. All the women agreed that all the listed strategies were capable of enhancing MHS. Women of child bearing age, aged 15-34 years and 35-49 years utilized ACS services to a high extent. ACS services in urban (=3.66) and rural (=3.58) locations were utilized of women of child bearing age to a high extent. There were significant differences in the utilization of MHS by women of child bearing age according to location, age, parity, location and level of education. Recommendations among others were that the Ministry of Health should increase the supply of MHS drugs and equipments in both urban and rural locations, and provide more basic amenities like toilets, lighting, delivery mats, detergents and water in these centers.

CHAPTER ONE

Introduction

Background to the Study

Maternal health services (MHS) are major health concern globally. This is because they support and determine the state of maternal health of any country. Maternal health is essential for the survival of human race in both developed and developing nations, including Nigeria. Global leaders reemphasized the reduction of maternal mortality as the fifth target of millennium development goals – MDGs (Lucas and Gill es, 2003). About 99 per cent of all maternal deaths occur in developing countries, while less than one per cent of maternal deaths worldwide occur in developed countries (Bayer, 2001). This indicates that maternal deaths could be avoided if the proper health resources and services were available to women in developing nations. Most of these conditions like obstructed labour could be prevented with proper provision and utilization of maternal health services.

MHS are those services provided to women of child bearing period (15-49 years) for prevention, early detection and treatment of health hazards or diseases that may affect the normal child bearing (Mahaba, 1996). MHS are essential obstetrics care with effective communication and transportation between the community-based services and the referral centre (Lucas & Gilles, 2003). They are also services planned for pregnant women and rendered to make them to be in good health during pregnancy, deliver safely, and maintain good health up to 6 weeks following delivery. To the best of my knowledge and accessibility no study was done on provision and utilization of maternal health services in Enugu state. In this study, MHS shall be regarded as organised services which are provided to cater for the health needs of women of child bearing age during pregnancy, delivery and post-natal periods. The objectives of MHS are to ensure that as far as possible pregnant women should remain healthy throughout pregnancy, deliver healthy babies and recover fully from the physiological changes that take place during pregnancy and delivery. These services include antenatal care services, delivery care services, and postnatal care services.

Antenatal care services are regarded as pregnancy related health care checkups, which could occur either in a health facility or at home. With improved understanding of the need for women to prepare physically, mentally and even logistically for childbirth, antenatal care is…..

 PROVISION, UTILIZATION, AND ENHANCEMENT STRATEGIES OF MATERNAL HEALTH SERVICES IN ENUGU STATE