AN ASSESSMENT OF THE QUALITY OF EMERGENCY OBSTETRIC CARE SERVICES IN GOVERNMENT-OWNED SECONDARY HEALTH FACILITIES IN ENUGU STATE

AN ASSESSMENT OF THE QUALITY OF EMERGENCY OBSTETRIC CARE SERVICES IN GOVERNMENT-OWNED SECONDARY HEALTH FACILITIES IN ENUGU STATE

Abstract

The Maternal mortality ratio in Nigeria has been described as unacceptably high (545/100,000 live births). Efforts are being made by governments at all levels to handle this ugly situation. One of such efforts is the introduction of Emergency Obstetrics Care (EmOC) services in health facilities in Enugu state. EmOC however exists in two parts, the Basic Emergency Obstetrics Care (BEmOC) which services are being offered at the primary health care level and the Comprehensive Emergency Obstetric Care (CEmOC) services which are being offered at the secondary and tertiary health care levels. This study is an assessment of the quality of CEmOC services in government-owned secondary health facilities in Enugu State.
A list of secondary health care facilities in the state was obtained from the Ministry of Health authorities. During the study, it was discovered that only twenty out of the forty seven health facilities in the list were offering maternity services and since the study was an assessment of the services provided in these facilities, the study was confined to the twenty facilities.
The study was in two parts; first was an assessment of the health facilities ie the environment, facility records, funding and personnel. Second was an assessment of the quality of services offered to the clients as perceived by the clients themselves.
Expectedly, there were two assessment tools; the health facility questionnaire/checklist and the clients’ interview questionnaire/form. The HF
questionnaire collected data on the water supply, power supply, sanitation, personnel types, motivation and trainings, hours of duty, components of EmOC services offered, referrals, ambulance services etc. The client questionnaire collected information from clients who benefited from the EmOC services in these centers and the information gathered were; the demographic characteristics of clients, components of EmOC services benefitted from, amount of time spent (delay) at each unit of the maternity, the attitude of the health personnel towards them, the perceived degrees of satisfaction obtained by a client at each unit, and finally the outcome of the services rendered to them i.e. the state of their new born.
The study discovered that only about 20 (42.6%) out of the 47 secondary health facilities in Enugu State offer EmOC services. Out of this proportion that offers the services, the assessment revealed that the quality of services varied from one facility to the other. Using the United Nations guidelines, it was discovered that only 5 (25%) out of the twenty five secondary health facilities in the state actually qualify as CEmOC centers.
In most of the facilities assessed, the water and power supply situations were very poor, power generating sets, where available, were not functional. The staff complained of poor motivation i.e. meager salaries and allowances. The components of EmOC services offered were not complete. Only very few large centers e.g. district and sub-district hospitals were found to be offering complete components of CEmOC services.
The clients complained of poor attitude of the health workers. An unwarranted amount of time was being spent by a client at the antenatal, natal and post natal units before getting attention from the health staff on duty. The clients also expressed their varying degrees of dissatisfaction with the services offered to them at the different units.
Finally, it is the intention of the researcher that the results of this study and the recommendations offered should be put into use by the authorities looking after
the health of the women of Enugu State. If this happens, there will be a significant degree of reduction in the MMR in the state

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

AN ASSESSMENT OF THE QUALITY OF EMERGENCY OBSTETRIC CARE SERVICES IN GOVERNMENT-OWNED SECONDARY HEALTH FACILITIES IN ENUGU STATE

 

Sharing is caring!