5 research outputs found
Demand for Women’s Health Services in Northern Nigeria: A Review of the Literature
Demand for and utilization of women‘s health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women‘s health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region‘s population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women‘s health-seeking behaviors for themselves and for their children. Programs seeking to improve women‘s health outcomes in northern Nigeria should involve women‘s influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services.Keywords: Maternal health, family planning, demand-side, Northern Nigeria, literature review La demande et l'utilisation des services de santé des femmes dans le nord du Nigeria sont toujours faibles et les indicateurs de santé dans la région sont parmi les plus pauvres du monde. Cette revue de la documentation se concentre sur les obstacles sociaux et culturels à l'utilisation de contraceptifs, les soins prénatals et les naissances dans des établissements dans le nord du Nigéria, et les influences du comportement de recherche de la santé des jeunes femmes. Une recherche approfondie de la documentation grise et évaluée par les pairs a permis d'obtenir 41 publications synthétisées et analysées. La population de la région est majoritairement musulmane, pratiquant l'islam comme toute une mode de vie. Tandis que la société au nord du Nigeria évolue lentement, la plupart des femmes manquent encore d'éducation formelle, avec une proportion importante mariée dans leur adolescence et la majorité n'étant ni socialement ni économiquement habilitée. Le mari prend en grande partie la plupart des décisions du ménage, y compris l'utilisation des services de santé par les membres de son ménage. Ces pratiques influent directement sur les comportements de recherche de la santé des femmes pour eux-mêmes et pour leurs enfants. Les programmes visant à améliorer les résultats de la santé des femmes dans le nord du Nigeria devraient impliquer les gens qui influencent des femmes pour affecter le changement de comportement, y compris les maris, les chefs religieux et d'autres. De plus amples recherches sont nécessaires pour identifier les voies d'information qui peuvent être utilisées par des programmes conçus pour accroître la demande de services de santé dans la région. Mots clés: santé maternelle, planification familiale, côté de la demande, nord du Nigeria, revue de la documentation
Demand for women’s health services in northern Nigeria: a review of the literature
Demand for and utilization of women‘s health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women‘s health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region‘s population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women‘s health-seeking behaviors for themselves and for their children. Programs seeking to improve women‘s health outcomes in northern Nigeria should involve women‘s influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services.Keywords: Maternal health, family planning, demand-side, Northern Nigeria, literature revie
Accountability for quality of care : monitoring all aspects of quality across a framework adapted for action
Quality of care is essential to maternal and newborn survival. The multidimensional nature of quality of care means that frameworks are useful for capturing it. The present paper proposes an adaptation to a widely used quality of care framework for maternity services. The framework subdivides quality into two inter-related dimensions—provision and experience of care—but suggests adaptations to reflect changes in the concept of quality over the past 15 years. The application of the updated framework is presented in a case study, which uses it to measure and inform quality improvements in northern Nigeria across the reproductive, maternal, newborn, and child health continuum of care. Data from 231 sampled basic and comprehensive emergency obstetric and newborn care (BEmONC and CEmONC) facilities in six northern Nigerian states showed that only 35%–47% of facilities met minimum quality standards in infrastructure. Standards for human resources performed better with 49%–73% reaching minimum standards. A framework like this could form the basis for a certification scheme. Certification offers a practical and concrete opportunity to drive quality standards up and reward good performance. It also offers a mechanism to strengthen accountability.PostprintPeer reviewe
Accountability for quality of care:monitoring all aspects of quality across a framework adapted for action
Quality of care is essential to maternal and newborn survival. The multidimensional nature of quality of care means that frameworks are useful for capturing it. The present paper proposes an adaptation to a widely used quality of care framework for maternity services. The framework subdivides quality into two inter-related dimensions—provision and experience of care—but suggests adaptations to reflect changes in the concept of quality over the past 15 years. The application of the updated framework is presented in a case study, which uses it to measure and inform quality improvements in northern Nigeria across the reproductive, maternal, newborn, and child health continuum of care. Data from 231 sampled basic and comprehensive emergency obstetric and newborn care (BEmONC and CEmONC) facilities in six northern Nigerian states showed that only 35%–47% of facilities met minimum quality standards in infrastructure. Standards for human resources performed better with 49%–73% reaching minimum standards. A framework like this could form the basis for a certification scheme. Certification offers a practical and concrete opportunity to drive quality standards up and reward good performance. It also offers a mechanism to strengthen accountability