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

listen audio

Study Justification:
– The study aims to evaluate consumers’ knowledge about available maternal and child health services in Southeast Nigeria.
– This is important because reducing child mortality and improving maternal health are key goals of the Millennium Development Goals (MDGs).
– If consumers are aware of the services available to them, they may be more motivated to use them.
Highlights:
– The study found that the majority of women surveyed were between 36-45 years old, married, had more than five children, and had at least a secondary school education.
– Maternal health services available in the area were mainly antenatal and delivery services, while immunization was the most available child health service.
– These services were primarily available at public and private hospitals, rather than at health centers that offer primary care at the community level.
– The study concluded that the knowledge of available services among women in the study area was not encouraging, and this poses a challenge for reducing child mortality and improving maternal health.
Recommendations:
– Awareness programs should be targeted towards consumers to increase their knowledge of available maternal and child health services.
– Referral points should be established at public and private hospitals, rather than relying solely on health centers for primary care.
– Efforts should be made to improve access to health facilities, especially during the rainy seasons when roads are impassable.
– User fees at public health facilities should be eliminated or reduced, and informal payments should be documented to ensure transparency.
Key Role Players:
– Local government authorities
– Health department officials
– Healthcare providers
– Community leaders
– Non-governmental organizations (NGOs)
– Women’s groups and associations
Cost Items for Planning Recommendations:
– Awareness campaign materials (brochures, posters, radio advertisements)
– Training programs for healthcare providers on maternal and child health services
– Infrastructure improvements for health facilities (road repairs, facility upgrades)
– Monitoring and evaluation activities to assess the impact of the recommendations
– Administrative costs for coordinating and implementing the recommendations

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study design is cross-sectional, which limits the ability to establish causality. However, the study provides detailed information about the sample size, data collection methods, and results. To improve the strength of the evidence, future research could consider using a longitudinal design to examine the relationship between knowledge of available health services and utilization. Additionally, including a control group could help to better understand the impact of awareness programs on consumer behavior.

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.

Based on the information provided, here are some potential innovations that could improve access to maternal health in the Ezeagu Local Government Area:

1. Mobile Health Clinics: Implementing mobile health clinics that can travel to hard-to-reach areas with poor road conditions during the rainy season. These clinics can provide essential maternal health services, including antenatal care and delivery services, to women in remote areas.

2. Community Health Workers: Training and deploying community health workers who can educate women about available maternal and child health services and provide basic care in their communities. These workers can also serve as a bridge between the community and health facilities, helping women navigate the healthcare system.

3. Telemedicine: Introducing telemedicine services that allow women to consult with healthcare providers remotely, reducing the need for long-distance travel to access primary care. This can be particularly beneficial for women in hard-to-reach areas or those with limited mobility.

4. Health Information Campaigns: Launching targeted awareness campaigns to educate women about the importance of maternal and child health services and where to access them. These campaigns can utilize various communication channels, such as radio, community meetings, and posters, to reach a wide audience.

5. Strengthening Health Facilities: Investing in improving the infrastructure and capacity of health facilities in the area, including public and private hospitals, health centers, and dispensaries. This can involve upgrading facilities, ensuring the availability of essential equipment and supplies, and training healthcare providers to deliver quality maternal health services.

6. Collaboration with Traditional Birth Attendants: Collaborating with traditional birth attendants and providing them with training and resources to ensure safe delivery practices. This can help integrate traditional birth attendants into the formal healthcare system and improve access to skilled birth attendance.

7. Transportation Support: Providing transportation support, such as ambulances or transportation vouchers, to pregnant women who need to travel long distances to reach health facilities. This can help overcome the challenge of poor road conditions and ensure timely access to maternal health services.

It is important to note that the implementation of these innovations should be tailored to the specific context and needs of the Ezeagu Local Government Area.
AI Innovations Description
Based on the information provided, a recommendation to improve access to maternal health in Southeast Nigeria could be to implement targeted awareness programs for consumers. These programs should focus on increasing knowledge about available maternal and child health services and where they can be obtained. By providing information to consumers, they can be motivated to utilize these services and make informed decisions about their healthcare. This recommendation aligns with the goal of reducing child mortality and improving maternal health, as outlined in the Millennium Development Goals (MDGs). Additionally, efforts should be made to improve the infrastructure and accessibility of healthcare facilities, especially in rural areas with hilly/stony topography and poor road conditions. This will ensure that women have easier access to the necessary healthcare services during all seasons.
AI Innovations Methodology
Based on the provided information, here are some potential recommendations to improve access to maternal health:

1. Increase awareness and knowledge: Develop and implement targeted awareness programs to educate women and their families about the available maternal and child health services in the area. This can be done through community outreach programs, health education campaigns, and the use of local media channels.

2. Improve transportation infrastructure: Address the issue of impassable roads during the rainy season by investing in road maintenance and improvement projects. This will ensure that pregnant women can easily access health facilities, especially during emergencies.

3. Strengthen primary healthcare services: Enhance the capacity and resources of primary healthcare centers in the area to provide comprehensive maternal and child health services. This includes training healthcare workers, ensuring the availability of essential medical supplies and equipment, and improving the quality of care provided.

4. Collaborate with traditional birth attendants: Engage with traditional birth attendants and provide them with training and support to ensure safe delivery practices. This can help bridge the gap between traditional and modern healthcare practices and improve access to skilled birth attendants.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Baseline data collection: Gather information on the current state of access to maternal health services in the study area. This can include data on the number of women utilizing services, distance to health facilities, and any barriers faced.

2. Define indicators: Identify specific indicators that will be used to measure the impact of the recommendations. This can include indicators such as the percentage increase in knowledge about available services, the reduction in travel time to health facilities, and the increase in utilization of primary healthcare services.

3. Intervention implementation: Implement the recommended interventions, such as awareness programs, infrastructure improvements, and capacity building initiatives. Monitor the implementation process and ensure that the interventions are carried out effectively.

4. Data collection post-intervention: After a sufficient period of time, collect data on the indicators identified in step 2. This can be done through surveys, interviews, or other data collection methods.

5. Data analysis: Analyze the collected data to assess the impact of the interventions on improving access to maternal health services. Compare the post-intervention data with the baseline data to determine any changes or improvements.

6. Evaluation and reporting: Evaluate the results of the analysis and report on the findings. This can include identifying the strengths and weaknesses of the interventions, highlighting any challenges faced, and making recommendations for further improvements.

By following this methodology, it will be possible to simulate the impact of the recommendations on improving access to maternal health and assess the effectiveness of the interventions implemented.

Share this:
Facebook
Twitter
LinkedIn
WhatsApp
Email