Building community ownership of maternal and child health interventions in rural Nigeria: A community-based participatory approach

Although community engagement has been widely reported in the literature, there have been limited reports of this approach in many African countries. We report the methods of community engagement used in an implementation research that was designed to increase women’s use of primary health centres for skilled pregnancy and child health care in rural Nigeria. The study was conducted in 20 communities in two Local Government Areas of Edo State in Nigeria. The study used a community-based participatory approach in engaging the project communities through all phases of the project cycle. Some of the activities for achieving community ownership of the project included advocacy activities and engagement with community stakeholders; community conversations; the identification and training of ward development committees; and community sensitization workshops. The project was implemented over three years - November 2017 to October 2020. Key informant interviews conducted at the end of the project reported narratives on key points that were appreciated by community members. These included the recognition given to the community members in decision-making, the elimination of costs through the health insurance scheme, the transparency and accountability embedded in the project implementation, and the absence of adverse maternal and child health outcomes during the project implementation. We conclude that the use of a community-based participatory approach enhanced the attainment of positive outcomes for a project designed to improve the use of skilled pregnancy care in rural Nigeri

Why rural women do not use primary health centres for pregnancy care : evidence from a qualitative study in Nigeria

Pregnant women in rural communities in Nigeria often do not use Primary Health Care Centres. Through focus group discussions, the study found four broad categories of reasons underlying non-use: 1) accessibility factors – poor roads and transportation, long distances, and facility not always open; 2) perceptions relating to poor quality of care, inadequate drugs, abusive care by health providers, long wait times, and inappropriate referrals; 3) costs of services, including inability to pay for services even when costs are not excessive; the introduction of informal payments by staff; and 4) partner support (or lack thereof), and misinterpretation of signs of pregnancy complications.Global Affairs Canada (GAC)Canadian Institutes of Health Research (CIHR

Maternal death review and outcomes : an assessment in Lagos State, Nigeria

Strong political will by hospital management and supervising government agencies are a prerequisite for effectively addressing the human and infrastructural deficits that predispose to maternal mortality in Lagos State. Failure to address the patients and facility-related causes of maternal mortality could account for the persistently high maternal mortality ratio (MMR) in the hospitals. Interventions aimed at redressing all causes identified in the reviews will likely reduce MMRs. The study investigates results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and reports outcomes and lessons learned

Trends plot of maternal mortality in Lagos state.

<p>An increase in MMR in LIMH (χ² = 17.97; df = 20; p = 0.590), in GGH ((χ² = 18.07; df = 20; p = 0.583) while a decrease in MMR was observed in AGH (χ² = 17.47; df = 20 p = 0.622). However, this observation was not significant at p<0.05.</p

Maternal deaths and Maternal Mortality Ratios (MMR) by health facilities.

<p>Maternal deaths and Maternal Mortality Ratios (MMR) by health facilities.</p

The major identified associated causes of maternal deaths in the hospitals.

<p>The major identified associated causes of maternal deaths in the hospitals.</p

Recommendations on preventing maternal deaths by health facilities.

<p>Recommendations on preventing maternal deaths by health facilities.</p

Medical causes (primary causes) of maternal deaths by health facilities.

<p>Medical causes (primary causes) of maternal deaths by health facilities.</p

Effect of a multifaceted intervention on utilization of primary health care for maternal and child health care in rural Nigeria

The study included 2,819 women participants of reproductive age. Among other intervention strategies, the project improved access to transportation while reducing associated expenses, and created a community health fund, both of which address well known barriers to the use of primary health centres (PHC). The study was designed to determine the effectiveness of various interventions in increasing the uptake of skilled maternal and child care in two rural Local Government Areas (LGA) in Edo State, Nigeria. Removal of out-of-pocket payments, and increased public funding of primary health care need to be considered as matters of equity and social justice.Global Affairs CanadaCanadian Institute for Health Researc

Maternal deaths by hospital booking status.

<p>Maternal deaths by hospital booking status.</p