Performance Needs Assessment of Maternal and Newborn Health Service Delivery in Urban and Rural areas of Osun State, SouthWest, Nigeria

Oluwaseun T. Esan, Adesegun O. Fatusi

Abstract

The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chisquare tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps. Afr J Reprod Health 2014; 18[2]: 105-116).

 

Keywords: Performance, maternal health services, health systems

 

Résumé 

L'étude avait pour objectif de déterminer les performances et comparer les lacunes en matière de service de santé maternelle et néonatale (SMN) services dans les zones urbaines et rurales de l'Etat d'Osun, au Nigeria, afin  d’éclairer les décisions pour assurer les meilleurs services. Cette étude concernait 14 établissements de CSP en milieu urbain et 10 en milieu rural qui ont été choisis au hasard. A l’aide d’un cadre d’évaluation des besoins de performance, les principales parties prenantes ont  déterminé les  performances souhaitées  et les performances réelles ont été mesurées en menant des enquêtes dans les établissements. Nous avons recueilli  des interviews basées sur des questionnaires auprès  de 143 agents de santé et 153 clients prénatals. Les écarts de performance ont été déterminés pour les zones urbaines et rurales et ont été comparés à l’aide  des tests de chi carré avec SPSS la version 17. On a  découvert qu’il y avait des lacunes importantes dans les établissements de CSP et chez les agents de santé dans l'État d'Osun, au Nigeria dans la performance du service SMN et ce qui est pire dans les zones rurales. La cause profonde de la plupart des écarts de performance était la mauvaise volonté politique des autorités locales. L'engagement du gouvernement à l'amélioration de SMN est nécessaire pour répondre à la plupart des lacunes. Afr J Reprod Health 2014; 18[2]: 105-116).

 

Mots-clés: performance,  services de santé maternelle, systèmes de santé

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