American Journal of Nursing Science

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Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria

Received: 15 July 2015    Accepted: 31 July 2015    Published: 10 August 2015
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Abstract

The unacceptably high maternal mortality in Nigeria led the Nursing and Midwifery Council of Nigeria to introduce the basic midwifery training with the view of producing skilled personnel to provide midwifery services. Built into the programme is the one-year mandatory community service. The one-year mandatory community service in an intervention aimed at ensuring the availability of midwives (skilled attendants) to provide maternal care in the communities and thus encourage women to access care at the health centre. The study investigated the variation in the levels of utilization of maternal healthcare before and after the inception of the one year mandatory midwives’ community service by assessing the perceptions of the Midwives regarding the impact of the mandatory service on the utilization of maternal care services. The General System Theory and the Logic Model were the theoretical models used in this study. The research was conducted in three selected local government areas (LGAs) out of the eighteen (18) LGAs in Ondo State. The time-series type of non-controlled experimental design was the research design used for the study. Records of maternal health care attendance from the selected health facilities from July 2002 to July 2010 were assessed to generate data for the study. The study population comprised the midwives who had participated in the mandatory service in the three selected communities where the three primary health care centres are located. Multistage sampling technique was adopted to select three Local Government Areas (LGAs) from where data was collected. All midwives that have served or are still serving in the selected PHCs were purposely involved, a total of 50 in number. In-depth interview guide and format for recording data from records were used in the study. The interview guide was divided into two sections. Section A, was a checklist was used to explore the participants’ opinions on the mandatory community service and Section B was a questionnaire to assess the midwives experience, opinions and challenges. Lastly, a format/checklist was developed to record data from records (antenatal care attendance, deliveries and postnatal care attendance between July 2002 and July 2011). Data from the study was analyzed using both descriptive and inferential statistics utilizing the Statistical Package for the Social Sciences (SPSS) Correlation coefficient was used. The result obtained from the study indicated that there was no significant difference in the levels of utilization of maternal care services before and after the inception of the mandatory community service except for the slight increase in antenatal care utilization. The majority of the midwives claimed that their presence had increased the patronage of maternal care services. However this subjective data was not justified by the statistics obtained. The midwives also highlighted their challenges as well as the way forward.

DOI 10.11648/j.ajns.20150404.23
Published in American Journal of Nursing Science (Volume 4, Issue 4, August 2015)
Page(s) 238-246
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Midwives, Maternal Care, Mandatory Community Midwifery Services

References
[1] World Health Organization Maternal Mortality in 2005; Estimate developed by WHO; UNFPA, UNICEF and the World Bank. Geneva. WHO. 2007.
[2] Shifman, J and Okonofua, F.E. (2007). The state of political priority for safe motherhood in Nigeria. International Journal of Obstetrics and Gynaecology, 114(2): 127-133.
[3] Indexmundi. (2015). Nigeria maternal mortality rate. [Online]. Available from: www.indexmundi.com/nigeria/maternal_mortality_rate.html (Accessed: 30/07/2015).
[4] UNICEF. (2015). Maternal and child health. [Online]. Available from: www.unicef.org/nigeria/children_1926.html (Accessed: 30/07/2015).
[5] Sarkar, P. (2009). Indicators of maternal health care services: Bangladesh context. Pakistan Journal of Social Sciences, 6(3): 169-172.
[6] National Population Commission (NPC). (2009). Nigeria demographic and health survey, 2008. [Online]. Available from: http://www.unicef.org/nigeria/ng_publications_Nigeria_DHS_2008_Final_Report.pdf (Accessed: 30/07/2015).
[7] World Health Organization. (2005). The world health report: make every mother and child court. Geneva. 2005.
[8] Thisdaylive. (2015). Global maternal mortality rate. [Online]. Available from: www.thisdaylive.com/articles/nigeria/183394 (Accessed: 30/07/2015).
[9] Obadare,O. (2010). Tackling Infant, Maternal Mortality in Ondo State. Sunday Punch, June 25.
[10] Hayajneh, Y. (2007). Management for health care professionals series systems and systems theory. Management for Health Care Professionals Series. [Online]. Available from: http://www.hayajneh.org/a/readings/Systems-Theory.pdf (Accessed: 30/07/2015).
[11] Kellogg, W.K. (2004). Using Logic Models to Bring Together Planning, Evaluation, and Action Logic Model Development Guide. [Online]. Available from: http://www.smartgivers.org/uploads/logicmodelguidepdf.pdf (Accessed: 30/07/2015).
[12] Babalola, S and Falusi, A. (2009). Determinant of use of Maternal Health Services in Nigeria looking beyond individual and household factors. Biomedical Central, Pregnancy and Childbirth, 9: 43.
[13] Mrisho, M., Obrist, B., Schellenberg, A.J., Haws, R.A., Mushi, A.K., Mshinda, H., Tanner, M and Schellenberg, D. (2009). The use of antenatal and postnatal care: Perspectives and experiences of women and health care providers in Rural Southern Tanzania. Biomedical Central, Pregnancy and Childbirth 9:10.
[14] Dharkal, S., Chapman, G.N., Simkhada, P.P., Teijlingen, E.R., Stephens, J and Raja, A.E. (2007). Utilization of Postnatal Care among Rural Women in Nepal. Biomedical Central Pregnancy and Childbirth, 7:19.
[15] Nursing and Midwifery Council of Nigeria (NMCN). (2004). Draft of Blueprint for Basic Midwifery Education and Practice.
Author Information
  • Department of Nursing, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria

  • Department of Nursing, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria

  • Department of Nursing, University of Ibadan, Oyo State, Nigeria

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  • APA Style

    Fadare R. I., Akpor O. A., Oyetunde M. O. (2015). Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria. American Journal of Nursing Science, 4(4), 238-246. https://doi.org/10.11648/j.ajns.20150404.23

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    Fadare R. I.; Akpor O. A.; Oyetunde M. O. Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria. Am. J. Nurs. Sci. 2015, 4(4), 238-246. doi: 10.11648/j.ajns.20150404.23

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    AMA Style

    Fadare R. I., Akpor O. A., Oyetunde M. O. Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria. Am J Nurs Sci. 2015;4(4):238-246. doi: 10.11648/j.ajns.20150404.23

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  • @article{10.11648/j.ajns.20150404.23,
      author = {Fadare R. I. and Akpor O. A. and Oyetunde M. O.},
      title = {Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria},
      journal = {American Journal of Nursing Science},
      volume = {4},
      number = {4},
      pages = {238-246},
      doi = {10.11648/j.ajns.20150404.23},
      url = {https://doi.org/10.11648/j.ajns.20150404.23},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajns.20150404.23},
      abstract = {The unacceptably high maternal mortality in Nigeria led the Nursing and Midwifery Council of Nigeria to introduce the basic midwifery training with the view of producing skilled personnel to provide midwifery services. Built into the programme is the one-year mandatory community service. The one-year mandatory community service in an intervention aimed at ensuring the availability of midwives (skilled attendants) to provide maternal care in the communities and thus encourage women to access care at the health centre. The study investigated the variation in the levels of utilization of maternal healthcare before and after the inception of the one year mandatory midwives’ community service by assessing the perceptions of the Midwives regarding the impact of the mandatory service on the utilization of maternal care services. The General System Theory and the Logic Model were the theoretical models used in this study. The research was conducted in three selected local government areas (LGAs) out of the eighteen (18) LGAs in Ondo State. The time-series type of non-controlled experimental design was the research design used for the study. Records of maternal health care attendance from the selected health facilities from July 2002 to July 2010 were assessed to generate data for the study. The study population comprised the midwives who had participated in the mandatory service in the three selected communities where the three primary health care centres are located. Multistage sampling technique was adopted to select three Local Government Areas (LGAs) from where data was collected. All midwives that have served or are still serving in the selected PHCs were purposely involved, a total of 50 in number. In-depth interview guide and format for recording data from records were used in the study. The interview guide was divided into two sections. Section A, was a checklist was used to explore the participants’ opinions on the mandatory community service and Section B was a questionnaire to assess the midwives experience, opinions and challenges. Lastly, a format/checklist was developed to record data from records (antenatal care attendance, deliveries and postnatal care attendance between July 2002 and July 2011). Data from the study was analyzed using both descriptive and inferential statistics utilizing the Statistical Package for the Social Sciences (SPSS) Correlation coefficient was used. The result obtained from the study indicated that there was no significant difference in the levels of utilization of maternal care services before and after the inception of the mandatory community service except for the slight increase in antenatal care utilization. The majority of the midwives claimed that their presence had increased the patronage of maternal care services. However this subjective data was not justified by the statistics obtained. The midwives also highlighted their challenges as well as the way forward.},
     year = {2015}
    }
    

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    VL  - 4
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