ASSESSMENT OF THE QUALITY OF MATERNAL HEALTH CARE SERVICES AT THE PRIMARY HEALTH CARE LEVEL IN NNEWI NORTH LOCAL GOVERNMENT AREA, ANAMBRA STATE

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ASSESSMENT OF THE QUALITY OF MATERNAL HEALTH CARE SERVICES AT THE PRIMARY HEALTH CARE LEVEL IN NNEWI NORTH LOCAL GOVERNMENT AREA, ANAMBRA STATE

Abstract

Introduction/Objective: Several efforts aimed at improving maternal health indices in Nigeria, have not yielded much fruit, as women are still dying from pregnancy related causes. This raises some doubts over the possibility of achieving the Millennium Development Goal (MDG) 5 by 2015, if the provision of quality maternal health care services starting from the Primary Health Care (PHC) level is not scaled up. This study assessed the quality of maternal health care services at the PHC level in Nnewi North Local Government Area of Anambra State, Nigeria and identified factors influencing it. Since no previous study addresses this issue at the primary health care level in the study area, this project is timely and therefore provides a baseline for further studies
Design and Method: A cross- sectional descriptive study was carried out at the primary health care level in Nnewi North Local Government Area, between January and March 2010. A total of two hundred and eighty (280) women attending maternal health services at the primary health care facilities in the local government area were selected by multistage sampling technique from four primary health care facilities and were studied. Data was collected from them using pretested semi structured interviewer-administered client exit questionnaires. This was complemented by health facility assessment done using observation checklist. Key informant interviews involving the heads of the facilities, and focus group discussions involving clients different from the ones enrolled for the exit interview were done.
Results: The mean age of the respondents was 29.2±5.9 years. Majority of the clients were married and attained at least secondary level of education. One hundred and sixty eight (60.0%) of the women studied accessed antenatal care services, 70 (25.0%) of them
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accessed post natal care services, 26 (9.3%) utilised delivery services and the remainder 16 (5.7%), other services. There were more difficulties in accessing maternal health services prior to arrival at the facility than at the facility and the reasons include: bad state of roads 170 (60.7%), lack of means of transportation 97 (34.6%) and high transportation cost 70 (25.0%). The study showed inadequacies of both human and material resources for the delivery of quality maternal health care services. None of the health facilities met with the National Primary Health Care Development Agency minimum requirement for manpower, equipment, essential drugs and supplies. None of the health centers had a pharmacy technician, laboratory technologists, medical records officer nor environmental health officers. None of the facilities had the capacity to provide basic Essential Obstetric Care (EOC). The record system was also poor as none of the facilities had a record officer. None had all the required Health Management Information System (HMIS) forms and the few available were incompletely filled. The referral system was poor as evidenced by lack of referral forms and vehicles for transportation during referral.
Conclusion: Generally, the quality of maternal health services provided in the health facilities studied was poor. The level of clients’ satisfaction was high and may be attributed to affordable cost of services rendered, good staff attitude and perception of waiting time which was fair. However there is need to improve the quality of maternal health services through upgrading of these facilities, employing and training of health personnel, improving the supply of equipment, drugs and supplies particularly for providing essential obstetric care, and basic amenities both for clients and the staff.

ASSESSMENT OF THE QUALITY OF MATERNAL HEALTH CARE SERVICES AT THE PRIMARY HEALTH CARE LEVEL IN NNEWI NORTH LOCAL GOVERNMENT AREA, ANAMBRA STATE

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