Factors That Influence The Utilization Of Maternal Health Care Centers (A Case Study Of Jabi Village FCT Abuja)

Medical and Health Science Project and Seminar Material

Abstract

This study was carried out to assess the factors that influence the utilization of maternal health care centers, using Jabi Village FCT Abuja as a case study. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of mothers and pregnant women in Jabi Village FCT Abuja. In determining the sample size, the researcher conveniently selected 70 respondents and all were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables. The result of the findings reveals that women’s age and literacy influences their utilization of maternal health care centers. The study also revealed that poor road networks, and challenging terrains influences the utilization of maternal health care centers. It was further discovered that lack of husbands support, and cost influences the utilization of maternal health care centers. To mention but a few. Therefore, it is recommended that the government should engage in the promotion of the social status of women through the provision of affordable, if not, free education. This will enable them the opportunity of acquiring the basic skills required to access and make effective use of health information. And aggressive public enlightenment and maternal health information distribution campaign should be embarked upon by all stakeholders (Healthcare providers, Medical librarians, Government parastatals, etc.) in order to achieve enhanced access and utilization of these information by the women.

Chapter One

Introduction

1.1 Background of the Study

Child bearing is one of the hazardous experiences that women engage in while bringing new life to this world. It is often associated with complications that may cause morbidities, disabilities, and mortalities. World Health Organization (WHO) estimates that more than half a million women lose their lives in the process of reproduction worldwide every year; of these deaths, about 99 percent are from developing countries. The share of Sub-Saharan Africa from the total death toll for developing countries is more than fifty percent and lifetime risk of dying from pregnancy is extremely high;that is, for every 26 mothers, one mother dies as the result of pregnancy and childbirth in Sub-Saharan Africa. This frequency is about 281 times more than the maternal death in more developed countries in which one mother dies from 7300 mothers(WHO, 2007).

In addition to the risk of dying during pregnancy and childbirth, many more women suffer from short and longterm maternal disabilities and illness. According to WHO (2001) for every maternal death, an estimated 30% to 50% women suffer pregnancy related health problems such as vesicovaginal fistulae, infertility, and depression that can be permanently debilitating.

Globally more than 70 percent of maternal deaths are due to five major complications (which are direct obstetric complications): hemorrhage (25 percent), infection (15 percent), complication of unsafe abortion (13 percent), hypertension (12 percent), and obstructed labor (8 percent). This complication can occur at any time during pregnancy and childbirth, often without fore warding and often requiring immediate access to emergency obstetric care for their management(Wagstaff and M. Claeson, 2004). The World Bank estimates that 74 percent of maternal deaths could be averted if all women had access to interventions that address complications of pregnancy and childbirth, especially emergency obstetric care(Wagstaff and M. Claeson, 2004). Similarly, studies that focused on maternal morbidity and mortality in developing countries have repeatedly recommended the need for antenatal care and availability of trained personnel to attend women during labor and delivery(Mcokay, 2009). ANC provides avenue to provide pregnant women with information, treat existing social and medical conditions, and screen for risk factors. However, it is not enough to receive ANC, since majority of the fatal complications occur during or shortly after delivery. It is therefore important that pregnant women have skilled obstetric attendance during delivery. However, utilization of these services in most developing countries such as Nigeria is constrained due to various cultural, socioeconomic, and demographic factors [Addai, 2017]. As the result disparities between developed and developing countries in terms of utilization of antenatal, delivery, and postnatal services are unfairly large, in developed countries, it is estimated that about 97 percent of the pregnant women receive ANC and 99 percent use skilled obstetric service at delivery, whereas in developing countries, only 65 percent and 53 percent of women use ANC and skilled obstetric care services, respectively [Addai, 2017].

Nigeria is one of the Sub-Saharan African countries that experience high maternal mortality ratios in the world. More than 400,000 women suffer long-term disabilities due to complications during pregnancy, delivery, or postpartum periods. The use of ANC, delivery, and postnatal services by Nigerian women is one of the lowest in the world. Almost all births take place at home in Nigeria, while few takes place in a health institute. The majority of the births are assisted by relatives or some other untrained person. Attendance of prenatal care is very low; only 28 percent of all Nigeria mothers received prenatal care from a trained heath professional. The quality and frequency of this care are variable; many women receive the care either too late or too few times in their pregnancy(Iyaniwura and Yussuf, 2014). Most maternal mortalities and disabilities in the country are due to direct obstetric complications, which are avoidable if women can get adequate and timely access to antenatal, delivery, and postdelivery services. In the light of the above, this study seek to ascertain the factors which influences the utilization of maternal health care centers.

1.2 Statement of the Problem

Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period1. Access and utilization of quality health services during pregnancy, at the time of delivery and in the post-natal period is critical for the survival and well-being of the mother and newborn (Iyaniwura and Yussuf, 2014). Though pregnancy is a normal physiological event, childbearing remains one of the most hazardous experiences that a woman engages in (Filippi, 2010); and for many women in LMIC’s it is often associated with suffering, ill health and child and maternal fatalities4. Critical to the success in reducing maternal deaths is the provision of maternal health care services such as antenatal care (ANC) and skilled birth assistance (SBA) in an equitable manner such that these services are available in the entire health system owing to its important role in ensuring safe motherhood and the overall well-being of families and communities(Engmann, C.M, & Devries, 2013)

In rural areas of Nigeria, several barriers to MHS utilization have been identified including: poor road networks, challenging terrains, lack of support from the family, community or health professionals, reliance on other people for decision-making, cost, cultural concerns such as continued use of traditional health providers, beliefs, and long distances to life-saving healthcare facilities(Ndep, & Ches, 2014). The five major causes of maternal deaths in Nigeria are severe bleeding, sepsis, hypertensive disorders in pregnancy, unsafe abortions and obstructed labour 16. Though much has been achieved through the MDGs in reducing maternal deaths, post-MDGs evaluation shows that progress remains uneven across and within countries, as underutilization of critical maternal health services remains disproportionate between the affluent and the marginalized communities(Wagstaff and Claeson, 2004) These sustainability concerns necessitated its inclusion in the present sustainable development goals. From the aforementioned, this study seek to identify the factors which influences the utilization of maternal health care centers in Abuja, Nigeria.

1.3 Objectives of the Study

The general focus of this study is the factors that influences the utilization of maternal health care centers in Abuja, Nigeria. However, the specific objectives which falls inline with the overall aim of this research are outlined below;

Determine whether women’s age and literacy influences the utilization of maternal health care centers.
Determine whether poor road networks, and challenging terrains influences the utilization of maternal health care centers.
Determine whether lack of husbands support, and cost influences the utilization of maternal health care centers.
Determine whether lack of community or health professionals, and unfriendly attitude of healthcare workers influences the utilization of maternal health care centers.
Determine whether inadequacy of health facilities, and cultural concernsinfluences the utilization of maternal health care centers.

1.4 Research Question

The study will be guided by the following questions;

Does women’s age and literacy influences their utilization of maternal health care centers?
Does poor road networks, and challenging terrains influences the utilization of maternal health care centers?
Does lack of husbands support, and cost influences the utilization of maternal health care centers?
Does lack of community or health professionals, and unfriendly attitude of healthcare workers influences the utilization of maternal health care centers?
Does inadequacy of health facilities, and cultural concerns influences the utilization of maternal health care centers?

1.5 Significance of the Study

The findings of this study may have both theoretical and practical implications for the future of suitability of maternal healthcare centers. Theoretically, the study may contribute to the advancement of knowledge about factors influencing the utilization of maternal health centers in Abuja. The study will also have practical significance in that, it will assist in determining the level of utilization of MHS at birth. The findings will be of immediate benefit to the Ministry of Health in the formulation of future public health policies aimed at integrating MHS in the health system as agents of change to enhance places of delivery. Similarly, results of this study may enlighten the public especially mothers and spouses on the importance of considering a suitable and safe place of delivery. In addition, this can lead to appropriate interventions by non-governmental organizations and other key stakeholders that have established or intend to establish reproductive health programs. The study may also forms a base on which others can develop their studies based on the gaps identified.

1.6 Scope of the Study

This study is structured to generally identify the factors that influences the utilization of maternal health care centers in Abuja, Nigeria. The respondents for this study will be obtained from mothers and pregnant women in Jabi Village FCT Abuja.

1.7 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

1.8 Definition of Terms

Women:

This refers to all females of reproductive age that is, 15 years to 49 years of age.

Choice of Place of Delivery:

This is the preferred option by the women who are giving birth; it could either be home, health facility or assisted by traditional birth attendant.

Maternal Health:

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience, in most cases, and reduce maternal morbidity and mortality, in other cases.
Maternal health care services include an extensive scope of health services mothers are given before pregnancy, during pregnancy, delivery and post-natal. Maternal health care services, therefore, comprise pre-natal care, childbirth and postnatal care.

Chapter Five

Summary, Conclusion and Recommendation

5.1 Summary

In this study, our focus was on the factors that influence the utilization of maternal health care centers, using Jabi Village FCT Abuja as a case study. The study is was specifically carried out to determine whether women’s age and literacy influences the utilization of maternal health care centers; determine whether poor road networks, and challenging terrains influences the utilization of maternal health care centers; determine whether lack of husbands support, and cost influences the utilization of maternal health care centers; determine whether lack of community or health professionals, and unfriendly attitude of healthcare workers influences the utilization of maternal health care centers; and determine whether inadequacy of health facilities, and cultural concerns influences the utilization of maternal health care centers.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 70 responses were validated from the enrolled participants where all respondent were mothers and pregnant women in Jabi Village FCT Abuja.

5.2 Conclusion

Based on the findings of this study, the researcher concluded that;

Women’s age and literacy influences their utilization of maternal health care centers.
Poor road networks, and challenging terrains influences the utilization of maternal health care centers.
Lack of husbands support, and cost influences the utilization of maternal health care centers.
Lack of community or health professionals, and unfriendly attitude of healthcare workers influences the utilization of maternal health care centers.
Inadequacy of health facilities, and cultural concerns influences the utilization of maternal health care centers.

5.3 Recommendation

Based on the responses obtained, the researcher proffers the following recommendations:

The government should engage in the promotion of the social status of women through the provision of affordable, if not, free education. This will enable them the opportunity of acquiring the basic skills required to access and make effective use of health information
Aggressive public enlightenment and maternal health information distribution campaign should be embarked upon by all stakeholders (Healthcare providers, Medical librarians, Government parastatals, etc.) in order to achieve enhanced access and utilization of these information by the women.
The governments at all levels (Federal, State and Local) should institute social policies that will enable the socio-economic development of the people. This will help in arresting the situation where women die unnecessarily following ignorance, lack of access to and utilization of maternal health information.
Medical librarians should repackage health information with the focus on the varying literacy status of the women since educational status has been established as a key variable.
Improving education of the population in general and women and girls in particular and availing appropriate package of maternal services to the disadvantaged groups could be an appropriate strategy to utilization of maternal health care services in the area.
Provision of information about the services provided in the health institutionsshould be strengthened by the concerned governmental and nongovernmental organizations so as to encourage mothers to utilize maternal health care services.
Access to the National Health Insurance Scheme must be expanded to include basic maternal health services for all, such that, funding of MHS no longer serves as a hindrance to care. The current situation where urban women under the employment of the federal government benefit from the social insurance program while the rural and semi-urban women have to pay out-of-pocket for health needs creates an imbalance that further widens the inequality that exists between these groups.

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