Opinion of women on emergency obstetric care provided in public facilities in Lagos, Nigeria: A qualitative study

Wright, Kikelomo Ololade; Banke-Thomas, Aduragbemi; Sonoiki, Olatunji; Ajayi, Babatunde; Ilozumba, Onaedo; Akinola, Oluwarotimi Ireti

doi:10.1080/07399332.2016.1234482

Cited by 27 publications

(33 citation statements)

References 34 publications

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“…Fears experienced by women, as reported by health workers, to accept referral to a district hospital such as fear of operations, blood donation, male health workers conducting births, and a new environment were largely similar to those previously reported by multiple studies in similar settings (16,18,28,29). A lingering fear of Ebola in district hospitals in post-Ebola regions including Sierra Leone has been described by several other studies (12,30,31).…”

Section: Improving Women's Compliance With Referralsupporting

confidence: 78%

Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

Proos

Mathéron²,

Nunes³

et al. 2020

Preprint

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BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes the perspectives of health workers in rural facilities in Sierra Leone concerning the referral of women with obstetric complications.MethodsWe conducted semi-structured group interviews with health care workers in nine peripheral health units in rural Sierra Leone regarding the referral of women with obstetric complications. Themes discussed were based on an interview guide. The data was analysed by systematic text condensation.ResultsPerspectives were grouped according to the following themes identified: 1) communication between health care workers; 2) underlying influences on decision-making; 3) women’s compliance to referral; 4) logistic constraints.ConclusionSeveral factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among health care workers for having maternal deaths or severe obstetric complications at their own facilities. Furthermore, the decision-making of health care workers concerning referral is negatively influenced by an atmosphere of hierarchy between health care workers. Such factors must be considered in efforts to reduce maternal mortality.

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Section: Improving Women's Compliance With Referralsupporting

confidence: 78%

Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

Proos

Mathéron²,

Nunes³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Finally, 317 articles were retrieved for full-text review, of which 280 studies were excluded for not meeting the eligibility criteria. Thirty-seven studies [ 38 – 73 ] were retained for the final qualitative analysis as shown in the PRISMA flow chart (Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-seven percent of the articles were published in 2014 while 24% published in 2016. Fifteen (40.6%) of the included articles were conducted with qualitative study designs [ 23 , 38 , 43 , 44 , 46 , 48 , 54 , 55 , 63 , 65 , 66 , 68 , 69 , 72 , 73 ], while 17 (45.9%) were quantitative [ 39 – 42 , 45 , 47 , 52 , 53 , 57 – 62 , 64 , 67 , 70 ] and five (13.5%) were mixed-methods studies [ 49 – 51 , 56 , 71 ]. Almost all of the studies were facility-based cross-sectional surveys.…”

Section: Resultsmentioning

confidence: 99%

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature

et al. 2018

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BackgroundNearly 15% of pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labour and complications of abortion. Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two thirds of these deaths occurred in sub-Saharan Africa. Though the majority of maternal mortalities can be prevented, different factors can hinder women’s access to emergency obstetric services. Therefore, this review is aimed at synthesizing current evidence on barriers to access and utilization of emergency obstetric care in sub-Saharan Africa.MethodsArticles were searched from MEDLINE, CINAHL, EMBASE, and Maternity and Infant Care databases using predefined search terms and strategies. Articles published in English, between 2010 and 2017, were included. Two reviewers (AG and AM) independently screened the articles, and data extraction was conducted using the Joanna Briggs Institute data extraction format. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The identified barriers were qualitatively synthesized and reported using the Three Delays analytical framework. The PRISMA checklist was employed to present the findings.ResultThe search of the selected databases returned 3534 articles. After duplicates were removed and further screening undertaken, 37 studies fulfilled the inclusion criteria. The identified key barriers related to the first delay included younger age, illiteracy, lower income, unemployment, poor health service utilization, a lower level of assertiveness among women, poor knowledge about obstetric danger signs, and cultural beliefs. Poorly designed roads, lack of vehicles, transportation costs, and distance from facilities led to the second delay. Barriers related to the third delay included lack of emergency obstetric care services and supplies, shortage of trained staff, poor management of emergency obstetric care provision, cost of services, long waiting times, poor referral practices, and poor coordination among staff.ConclusionsA number of factors were found to hamper access to and utilization of emergency obstetric care among women in sub-Saharan Africa. These barriers are inter-dependent and occurred at multiple levels either at home, on the way to health facilities, or at the facilities. Therefore, country-specific holistic strategies including improvements to healthcare systems and the socio-economic status of women need to be strengthened. Further research should focus on the assessment of the third delay, as little is known about facility-readiness.Systematic review registrationPROSPERO CRD42017074102Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0842-2) contains supplementary material, which is available to authorized users.

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“…The high MMR in referral hospitals in this study is possibly indicative of the poor state of emergency obstetric care in referral hospitals in Nigeria, which have been reported in several previous publications. 7 , 11 , 19 – 21 Thus, it is evident that poor quality emergency obstetric care needs to be urgently addressed as part of efforts to reduce MMR in referral facilities in the country.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: a multicenter study

Ntoimo¹,

Okonofua²,

Ogu³

et al. 2018

IJWH

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IntroductionWhile reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria.MethodsA pretested study protocol was used over a 6-month period (January 1–June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria. Data were analyzed centrally using univariate, bivariate, and multivariate statistics.ResultsThe results show an MMR of 2,085 per 100,000 live births in the hospitals (range: 877–4,210 per 100,000 births). Several covariates were identified as increasing the odds for maternal mortality; however, after adjustment for confounding, five factors remained significant in the logistic regression model. These include delivery in a secondary health facility as opposed to delivery in a tertiary hospital, non-booking for antenatal and delivery care, referral as obstetric emergency from nonhospital sources of care, previous experience by women of early pregnancy complications, and grandmultiparity.ConclusionMMR remains high in referral health facilities in Nigeria due to institutional and patient-related factors. Efforts to reduce MMR in these health facilities should include the improvement of emergency obstetric care, public health education so that women can seek appropriate and immediate evidence-based pregnancy care, the socioeconomic empowerment of women, and the strengthening of the health care system.

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Opinion of women on emergency obstetric care provided in public facilities in Lagos, Nigeria: A qualitative study

Cited by 27 publications

References 34 publications

Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature

Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: a multicenter study

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