Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria

Abstract

BackgroundLate arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care.ObjectivesTo determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria.MethodsThirty-six hospital managers, heads of obstetrics department and senior midwives were interviewed about hospital infrastructure, resources, policies and processes relating to emergency obstetric care, whilst allowing informants to discuss their thoughts and feelings. The interviews were audiotaped, transcribed and analyzed using Atlas ti 6.2software.ResultsHospital managers are aware of the seriousness of maternal mortality and the steps to improve maternal healthcare. Many reported the lack of policies and specific action-plans for maternal mortality prevention, and many did not purposely disburse budgets or resources to address the problem. Although some reported that maternal/perinatal audit take place in their hospitals, there was no substantive evidence and no records of maternal/perinatal audits were made available. Respondents decried the lack of appropriate data collection system in the hospitals for accurate monitoring of maternal mortality and identification of appropriate remediating actions.ConclusionHealthcare managers are handicapped to properly manage the healthcare system for maternal mortality prevention. Relevant training of healthcare managers would be crucial to enable the development of strategic implementation plans for the prevention of maternal mortality.

Assessing the knowledge and skills on emergency obstetric care among health providers: Implications for health systems strengthening in Nigeria

“…Within sub-Saharan Africa, nearly 29% of the maternal deaths occurred in Nigeria with an estimated 58,000 pregnant women dying annually in the country mainly from preventable obstetric causes [1, 2]. While many socio-economic and cultural factors have been put forward to explain the high rates of maternal deaths in Nigeria [3, 4], it is evident that the poor accessibility of pregnant women to quality emergency obstetric care (EMOC) is at the root of the problem. The WHO defines EMOC as “a list of live-saving services or signal functions that define a health facility with regard to its capacity to treat obstetric emergencies” [5].…”

Improving Maternal Health: The Safe Childbirth Checklist as a Tool for Reducing Maternal Mortality and Morbidity

“…Specifically, healthcare workers must prepare essential supplies and also prepare themselves to take essential actions. Advocacy to hospital managers should be undertaken [21], and innovation for supplies availability periodically carried out. The essential supplies must always be available, functioning and ready to use before the birth occurs.…”

Improving maternal health:Women’s attitude to antenatal care utilization is crucial

“…The poor maternal health outcome in Nigeria could be a result of poor ANC coverage and utilization [7,8]. The importance of ANC services in enhancing maternal health during pregnancy and influencing the outcomes of pregnancy have been shown in previous studies [6,[9][10][11]. ANC allows for prevention, early identification and management of conditions that could be aggravated by pregnancy or threatening to the mother and/or her baby.…”