Is poor maternal mortality index in Nigeria a problem of care utilization? A case study of Anambra State
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Abstract
Maternal mortality in Nigeria is unacceptably high. Some of the reasons may include poor socioeconomic development, weak health care system, low socioeconomic status of women and socio-cultural barriers to care utilization.
A cross sectional study was carried out to assess the use of maternal services in Anambra State. A multi stage sampling technique was used to select 800 nursing mothers from the State who were interviewed on the use of maternal services during their last pregnancy.
Over 95% of the subjects had formal education. Almost all the subjects (99.7%) attended antenatal clinics during their last pregnancy with 92.3% (646) of them making 4 or more visits before delivery. Over 97%(680) of the deliveries took place in formal health facilities. Obviously, the women in the study population utilize maternal health services. The problem of maternal mortality in the country may not necessarily lie with utilization but with the quality of services. (Afr J Reprod Health 2008; 12[2]:132-140)
RÉSUMÉEst-ce qu´un mauvais indice de la mortalité maternelle au Nigéria constitue un problème de l´utilisation des soins? Une étude de cas de l´ Etat d´ Anambra. La mortalité maternelle au Nigéria est si élevée que c´est inacceptable. Parmi les raisons on peut citer le développement socio- économique, un mauvais système de soins médicaux, la mauvaise situation socio-économique de la femme et les obstacles socio-culturels à l´utilisation de soins. Une étude transversale a été menée pour évaluer l´emploi des services maternels dans l´Etat d´ Anambra. A l´aide d´une technique d´un échantillon à multi-stade, nous avons selectionné 800 mères qui allaitent qui ont été intérrogées sur l´utilisation des services maternels au cours de leurs dernières grossesses. Plus de 95% des sujets ont suivi une scolarité formelle. Presque tous les sujets (99,7%) ont fréquenté les consultations des services prénatals pendant leur dernière grosssesse alors que 92,3% (646) d´elles se sont présentées 4 fois ou plus avant l´ accouchement. Plus de 97% (680) des accouchements ont eu lieu dans des établisements de santé formels. Evidemment les femmes dans la population étudiée utilisent des services de santé maternelle. Le problème de la mortalité maternelle dans le pays peut ne pas nécessairement rester celui de l’utilisation mais celui de la qualité des services. (Rev Afr Santé Reprod 2008; 12[2]:132-140)
KEY WORDS: Maternal mortality, maternal services, care utilization
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