Obstetric outcome following free maternal care at Enugu State University Teaching Hospital (ESUTH), Parklane, Enugu, South-eastern Nigeria

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Study Justification:
– The study aims to determine the impact of free maternal care on the utilization of available delivery services and evaluate the obstetric outcome.
– It addresses the issue of cost barriers limiting women’s access to healthcare in developing countries.
– The study contributes to the achievement of Millennium Development Goals (MDGs) 4 and 5, which focus on reducing child mortality and improving maternal health.
Study Highlights:
– Introduction of free maternal care led to an 88% increase in the number of deliveries at ESUTH, Parklane.
– Within 4 months of the termination of free services, there was a 30% drop in the number of deliveries.
– Maternal mortality ratio (MMR) slightly decreased.
– Morbidity increased significantly, as well as the stillbirth rate, particularly intrapartum stillbirth.
Study Recommendations:
– Address the cost barriers that limit women’s access to healthcare.
– Ensure the availability and sustainability of free maternal care services.
– Improve the quality of care to reduce morbidity and stillbirth rates.
Key Role Players:
– Government health agencies and policymakers.
– Hospital administrators and staff.
– Community leaders and organizations.
– Non-governmental organizations (NGOs) working in healthcare.
Cost Items for Planning Recommendations:
– Funding for free maternal care services.
– Training and capacity building for healthcare providers.
– Infrastructure and equipment upgrades.
– Community outreach and education programs.
– Monitoring and evaluation systems.
– Research and data collection.
– Administrative and management support.

This study aims to determine the impact of free maternal care on the utilisation of the available delivery services and to evaluate the obstetric outcome. All deliveries at ESUTH, Parklane within the 4 months of free maternal care from 1 September to 31 December 2008 were studied and compared with deliveries that took place 4 months before and after the free services. The results were analysed using Epi-info statistical software version 3:2:2. There was an 88% rise in the number of deliveries with the introduction of free maternal services and a 30% drop within 4 months of its termination. The maternal mortality ratio (MMR) dropped slightly, but morbidity increased significantly, as well as stillbirth rate (77/1,000 births), especially intrapartum stillbirth. Cost barrier limits women’s access to healthcare in developing countries and must be addressed if we aim to achieve Millennium Development Goals (MDGs) 4 and 5. © 2011 Informa UK, Ltd.

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Based on the provided description, here are some potential innovations that could improve access to maternal health:

1. Implementing sustainable and affordable free maternal care programs: Based on the study’s findings, the introduction of free maternal care services led to a significant increase in the number of deliveries. Continuing and expanding such programs could help improve access to maternal health services.

2. Addressing cost barriers: The study highlights that cost barriers limit women’s access to healthcare. Innovations that focus on reducing or eliminating the financial burden associated with maternal health services, such as subsidized or low-cost healthcare options, could help improve access.

3. Improving transportation infrastructure: Access to healthcare facilities can be challenging in some areas, particularly in developing countries. Innovations that improve transportation infrastructure, such as providing ambulances or implementing mobile health clinics, could help ensure that pregnant women can reach healthcare facilities in a timely manner.

4. Enhancing community-based healthcare initiatives: Community-based healthcare initiatives, such as training and empowering local healthcare workers or traditional birth attendants, could help improve access to maternal health services, especially in remote or underserved areas.

5. Utilizing technology for telemedicine: Telemedicine, which involves using technology to provide healthcare remotely, could be utilized to improve access to maternal health services. This could include virtual consultations, remote monitoring of pregnancies, or providing educational resources through mobile applications.

It’s important to note that these recommendations are based on the provided study’s findings and may need to be adapted to specific contexts and resources available in different regions.
AI Innovations Description
Based on the information provided, the recommendation to improve access to maternal health could be to implement a sustainable and affordable maternal health insurance program. This program could be designed to cover the costs of prenatal care, delivery services, and postnatal care for pregnant women. By addressing the cost barrier, more women would have access to essential maternal health services, leading to improved obstetric outcomes and reduced maternal and infant mortality rates. Additionally, efforts should be made to raise awareness about the availability and benefits of the free maternal care services to ensure that women are informed and encouraged to utilize them.
AI Innovations Methodology
Based on the provided description, here are two potential recommendations for improving access to maternal health:

1. Implementing a sustainable and affordable healthcare financing model: This recommendation involves developing a healthcare financing model that ensures access to maternal health services without imposing significant financial burdens on women. This could include strategies such as health insurance schemes, subsidies for maternal health services, or public-private partnerships to reduce costs and increase affordability.

2. Strengthening community-based healthcare services: This recommendation focuses on improving access to maternal health services at the community level. It involves training and equipping community health workers to provide basic antenatal care, postnatal care, and emergency obstetric care. Additionally, establishing mobile clinics or outreach programs can help reach remote or underserved areas, ensuring that pregnant women have access to essential maternal health services.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could be developed as follows:

1. Define the indicators: Identify key indicators that reflect access to maternal health, such as the number of antenatal care visits, the percentage of deliveries attended by skilled birth attendants, and the maternal mortality ratio.

2. Collect baseline data: Gather data on the current status of these indicators in the target population or region. This data will serve as a baseline for comparison.

3. Develop a simulation model: Create a simulation model that incorporates the potential impact of the recommendations on the identified indicators. This model should consider factors such as population demographics, healthcare infrastructure, and financial resources.

4. Input data and run simulations: Input relevant data into the simulation model, including the proposed changes resulting from the recommendations. Run multiple simulations to assess the potential impact under different scenarios.

5. Analyze results: Analyze the simulation results to determine the projected impact of the recommendations on improving access to maternal health. This analysis should consider both quantitative indicators (e.g., changes in the number of antenatal care visits) and qualitative factors (e.g., improved satisfaction with maternal health services).

6. Refine and validate the model: Continuously refine and validate the simulation model based on real-world data and feedback from stakeholders. This iterative process will help improve the accuracy and reliability of the simulations.

By following this methodology, policymakers and healthcare providers can gain insights into the potential impact of specific recommendations on improving access to maternal health. This information can guide decision-making and resource allocation to achieve better maternal health outcomes.

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