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

Fadare, R. I and Akpor, O. A and Oyetunde, M. O Effect of the Mandatory Community Midwifery Service on Maternal Health Care Utilization in Nigeria. American Journal of Nursing Science. ISSN 328-5753

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Abstract

The unacceptably high maternal mortality in Nigeria led the Nursing and Midwifery Council of Nigeria t o introduce the basic midwifery training with the vie w of producing skilled personnel to provide midwife ry services. Built into the programme is the one-year mandatory community s ervice. The one-year mandatory community service in an intervention aimed at ensuring the availability of midwives (ski lled attendants) to provide maternal care in the co mmunities and thus encourage women to access care at the health centre . The study investigated the variation in the level s of utilization of maternal healthcare before and after the inception of the on e year mandatory midwives’ community service by ass essing the perceptions of the Midwives regarding the impact of the mandato ry service on the utilization of maternal care serv ices. The General System Theory and the Logic Model were the theoreti cal models used in this study. The research was con ducted in three selected local government areas (LGAs) out of the e ighteen (18) LGAs in Ondo State. The time-series ty pe of non-controlled experimental design was the research design used fo r the study. Records of maternal health care attend ance 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 serv ice in the three selected communities where the thr ee 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 o r are still serving in the selected PHCs were purpo sely involved, a total of 50 in number. In-depth interview guide and format f or recording data from records were used in the stu dy. The interview guide was divided into two sections. Section A, was a che cklist was used to explore the participants’ opinio ns on the mandatory community service and Section B was a questionnaire to assess the midwives experience, opinions and ch allenges. 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 stu dy was analyzed using both descriptive and inferent ial statistics utilizing the Statistical Package for the Social Sciences (SP SS) Correlation coefficient was used. The result ob tained from the study indicated that there was no significant difference in the levels of utilization of maternal care servi ces before and after the inception of the mandatory community service except for the slight increase in antenatal care utilizat ion. The majority of the midwives claimed that their presence had increased the patronage of maternal care services. However th is subjective data was not justified by the statistics obtained. The midwi ves also highlighted their challenges as well as th e way forward.

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