Consumer knowledge and availability of maternal and child health services: A challenge for achieving MDG 4 and 5 in Southeast Nigeria

Background: Reducing child mortality and improving maternal health occupies a prominent space in the Millennium Development Goals (MDGs), and it has been noted that some reductions have taken place, but not enough. If consumers know what and where services are available, they may be motivated to use them. This study therefore evaluated consumers’ knowledge about available maternal and child health services and where these services can be obtained in the study area. Although knowledge of available health services does not translate to utilization of these services, this study is important as knowledge of available health services can prompt the informed use of services. The study determined the consumers’ knowledge about available Maternal and Child Health services and where these services are available. Methods. The study was a cross-sectional research design. The sample for the study consisted of a total of 450 women of child bearing age selected from the 20 political wards that make up Ezeagu Local Government Area. The 20 political wards constituted 20 clusters (cluster sampling technique) i.e. one cluster per political ward. Simple random sampling method by balloting was used to select five (5) wards out of the 20 political wards. Finally, a total of 90 women of childbearing age were selected from each of the five wards (clusters) using simple random method. Results: The study showed that majority of the women (37.3%) were between 36-45 years, married [49.5%], had more than five children [21.6%], hold at least SSCE [23.7%], and were farmers and Christians [32.3% and 81.8%] respectively. Maternal health services available are mainly antenatal [57%] and delivery services [54.3%]. Other available services are described at the results section. In the same vein, immunization [63.8%] was the most available child health service in the area. Both Maternal and Child Health services were available mainly at public and private hospitals [53.6% and 52.3% for maternal services; 56.1% and 53.9% respectively for child health services] respectively [see result section for details]. Conclusions: Available Maternal and Child Health services known to mothers in the study area were not encouraging, and these are structurally contextual. ANC and delivery services for mothers, and immunization for children were found to be available as indicated by at least more than half of the respondents. The women knew that these services were available mostly in public and private hospitals which should constitute referral points instead of the health centers that offer primary care at community level. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015. This suggests that the women in the study area do not use primary health care services adequately, and may be incurring huge indirect costs and at the same time travel too far to obtain primary care. This is therefore quite challenging for reducing child mortality and improving maternal health in southeast Nigeria. Knowledge of available services is important for consumers to make use of the services. Awareness programmes should be targeted more on the consumers if the MDG 4 and 5 must be reached by 2015. © 2013 Emmanuel et al.; licensee BioMed Central Ltd. Ezeagu Local Government Area was created out from Udi Local Government Area in 1975 and the headquarters is located at Aguobu-Owa. It is situated in the Enugu north senatorial district. The Area shares common boundaries with Uzo uwani Local Government Area in the east, Orji River L.G.A in the south, Udi L.G.A in the west and Ebenebe community in Anambra State in the north. It is about 17 km from the State capital. Most of the people are farmers and petty traders. Christianity is widely practiced in the area. Ezeagu L.G.A is wholly a rural setting with hilly/stone topography and many hard-to-reach areas. The Local Government Area has a population of 169,718, (84,053 males and 85,665 females). The L.G.A is divided into four development council areas, namely Ezeagu Central, Ezeagu South, Ezeagu North and Ezeagu East. There are 20 political wards and 30 health facilities owned by the government scattered all over 25 communities, all sited for easy reach to the people. Ezeagu L.G.A is wholly a rural setting with hilly/stony topography and many hard-to-reach areas. These 30 public health facilities include four secondary health facility [cottage Hospitals], while others are health centers, health posts and dispensaries. There are very few private hospitals and less than 10 pharmacies as well, with numerous traditional birth attendants and patent medicine dealers, even though drug itinerancy is widely practiced. The people strongly believe in herbal medicine and consent to utilizing TBA services. However, the roads to the facilities are not in good shape and almost impassable and this poses a great challenge to access to the facilities especially during the rainy seasons. At the public health, user fees are not charged except for informal payments which are not usually documented. The study was a cross-sectional research design using a household survey and the sample for the study consisted of a total of 450 women of child bearing age selected from the 20 political wards that make up Ezeagu Local Government Area. The 20 political wards constitute 20 clusters (cluster sampling technique). Simple random technique by balloting was used to select five (5) wards out of the 20 political wards. Below is the breakdown of sample size calculation: N = sample Size Za2 = Significance level at 95% or 1.96 P = Prevalence (50% or 0.5) D2 = Error tolerated at 5% Therefore Therefore N (minimum sample size) = 384 Add 17% for non responses = 15/100 × 384 = 66 Total = 450 Finally a total of 450 women of childbearing age were selected for the study. However, 90 women were selected from each of the five wards (clusters) using simple random technique making a total of 450 women. The instrument for the data collection was a pretested interviewer administered questionnaire designed for the study. The questions were unprompted allowing responses from the respondents without any bias. The questionnaire was administered in the local language [Igbo], unless where the participant was literate enough and demanding no explanations (Additional file 1). Informed consent of the women was duly obtained before the questionnaire was administered. Only those who consented to the study were included. Women of childbearing age who have used the services either for themselves or for their children were included in the study.