PATTERNS OF UTILIZATION OF MATERNAL HEALTH SERVICES IN PRIMARY HEALTH CARE FACILITIES IN NIGERIA
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CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Maternal Mortality Ratio (MMR) reduction is still a global health concern. Despite significant advancements over the previous 15 years, the MMR remains high, particularly in Low- and Middle-Income Countries (LMICs) (World Health Organization.. The World Health Organization (WHO) reports that high MMR is seen in Sub-Saharan African and Asian nations (WHO, 2018). A number of worldwide conferences and initiatives have focused on reducing maternal mortality and morbidity. Most programs, with a focus on women and children in particular, have attempted to improve the quality, accessibility, and utilization of health services by all people since the introduction of primary health care in 1978 through the Bamako Initiative, Safe Motherhood, and the Millennium Development Goals (Hiluf and Fantahun, 2008). The implementation of various health policies and programs in many developing nations led to disparities in terms of coverage of citizens and quality of services available to the public, rather than enhancing access, quality, and utilization of health services (Ha, Berman, and Larson, 2002).
Preconception, prenatal, postnatal, and family planning are all included in the maternal health care service. Preconception care aims to eliminate risk factors that could influence future pregnancies by offering therapies to women of reproductive age, as well as health promotion, screening tests for a range of health issues, and education. Pregnant women who receive early prenatal care had better birth outcomes than those who receive little to no treatment at all. According to Mwaniki, Kabiru, and Mbugua (2002), postnatal care considerations include nursing, nutrition, recuperation from labor, and family planning.
Maternal health care services (MCH) offer avenues for the early detection of mothers at high risk of illness and mortality during pregnancy, labor, and the postnatal period. MCH is primarily preventive and promotive (Al-Nahedh, 1995; Lucas and Gilles, 2003; Olugbenga-Bello, Asekun-Olarinmoye, Adewole, Adeomi and Olarewaju, 2013). Given that the majority of patients who use MCH services are typically not sick and that pregnancy is typically an unremarkable physiological process, it becomes sense to speculate that maternal health services would be underutilized in the event of even minor limits.
Ensuring that expecting and nursing moms have a normal delivery, bear healthy children, and maintain good health is the goal of maternal health care. This procedure begins at the moment of the child’s conception (Rogan and Olvena, 2004). While prenatal care safeguards expectant women’ health, particularly their nutritional status, and prevents preventable pregnancy issues, natal care also involves care for expectant moms during labor, preferably from a nurse, midwife, or doctor. Family planning ensures that the woman fully recovers from her previous childbirth and increases the child’s probability of survival, whereas postnatal care covers maternal health care services following delivery, including health monitoring of the newborn baby (Digambar and Sahoo, 2011).
Accordingly, the United Nations Fund for Population Activities (UNFPA, 2006) said that the provision of prenatal care, expert help for uneventful births, proper referral for women with obstetric difficulties, and postnatal care are the primary goals of maternal health care services. Provision of family planning and other reproductive health services, including emergency obstetric care, infertility treatment, and the ability to have a caesarian section and get emergency blood transfusions, are additional goals. These services must be rendered by qualified medical professionals in the community as part of the primary healthcare program. According to reports, a society’s level of social justice and respect for women’s rights is reflected in its maternal health (United Nations, 2001). When women’s essential human rights to education, healthy nutrition, a safe environment, access to financial resources, and decision-making are fulfilled, their right to obtain high-quality health services is ensured (WHO/UNICEF/UNFPA, 1999; USAID, 2013).
Maternal and child health is one of the components of Primary Health Care (PHC), which was recognized by the World Health Organization (WHO) in 1978 as the best strategy for the provision of health care services. However, the extent of the issues women face during pregnancy and childbirth were highlighted at the Nairobi Safe Motherhood Conference in 1987 (Starrs, 1997). The Nairobi meeting gave rise to the Safe Motherhood Initiative, which outlined tactics for promoting safe motherhood in line with the fundamentals of basic healthcare. These values include community involvement in health care services, prevention over cure, and fair distribution of health care services. According to the WHO (1987), the Bamako Initiative, which was introduced by the African Ministers of Health in 1987 as a means of guaranteeing access to necessary medications, places a strong emphasis on the development of maternal and child health.
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