CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Maternal health is a critical aspect of public health, and ensuring access to quality healthcare services during pregnancy and childbirth is imperative for the well-being of both mothers and newborns. In the context of Nigeria, a country with a diverse socio-economic landscape, there exists a significant disparity in the accessibility and utilization of maternal health services, particularly in rural areas. This study aims to assess the accessibility and utilization of maternal health services in rural Nigeria, shedding light on the challenges and opportunities that impact the delivery and uptake of these essential services. World Health Organization. (2016).
In rural areas of Nigeria, numerous factors contribute to the limited accessibility of maternal health services, including geographical barriers, inadequate infrastructure, and a shortage of healthcare professionals. Understanding these challenges is crucial for the development of targeted interventions that can improve the overall maternal health landscape in these underserved regions. This research will employ a comprehensive approach, combining both qualitative and quantitative methods, to explore the experiences and perceptions of pregnant women, healthcare providers, and community stakeholders. By examining the existing healthcare infrastructure, community awareness, and cultural factors influencing maternal health utilization, this study aims to provide valuable insights for policymakers and healthcare practitioners. Federal Ministry of Health Nigeria. (2019).
To build on existing literature and contribute to the discourse on maternal health in Nigeria, this research draws upon a range of reputable sources. Notable references include the World Health Organization's guidelines on maternal and newborn health, ensuring a global perspective on best practices. Additionally, studies focusing on maternal health in similar contexts, such as Sub-Saharan Africa, offer valuable insights that can be applied to the Nigerian context. Moreover, research articles from peer-reviewed journals, national health surveys, and reports from organizations like UNICEF and the Nigerian Ministry of Health will be essential in providing a nuanced understanding of the current state of maternal health services in rural Nigeria. Through this comprehensive assessment, the study endeavors to inform evidence-based policies and interventions that can contribute to the enhancement of maternal health outcomes in the country's rural areas. (UNICEF). (2020).
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1.2 Statement of the Problem
Maternal health remains a critical concern in Nigeria, particularly in rural areas where accessibility and utilization of services pose significant challenges. Despite efforts to improve healthcare infrastructure and services, numerous barriers hinder pregnant women from accessing essential maternal health services. Limited transportation options, inadequate healthcare facilities, and a shortage of skilled healthcare providers in rural areas contribute to delays in seeking and receiving timely maternal care. Additionally, cultural factors and lack of awareness about the importance of antenatal and postnatal care further compound the issue. This study aims to comprehensively assess the current state of maternal health services in rural Nigeria, identify the key barriers to accessibility and utilization, and propose targeted interventions to address these challenges. World Health Organization. (2016).
The lack of adequate and timely maternal healthcare in rural areas not only jeopardizes the well-being of expectant mothers but also contributes to preventable maternal morbidity and mortality. Understanding the multifaceted nature of these challenges is crucial for developing effective strategies that address the root causes and promote sustained improvement in maternal health outcomes. This research seeks to provide evidence-based insights that can inform policy decisions, guide resource allocation, and ultimately enhance the accessibility and utilization of maternal health services in Nigeria's rural communities. By identifying and addressing the specific impediments faced by pregnant women in these areas, we aim to contribute to the ongoing efforts to reduce maternal mortality rates and improve overall maternal health in the country. Federal Ministry of Health Nigeria. (2019).Top of FormBottom of Form
1.3 Objectives of the Study
The main objective of the study is to examine Assessment of Maternal Health Services Accessibility and Utilization in Rural Areas in Nigeria. Specific objectives of the study are:
- 1. Assess the geographic and financial accessibility of maternal health services in rural Nigerian communities.
- 2. Evaluate the quality and utilization of maternal health services offered in rural health facilities.
- Explore socio-cultural factors influencing the utilization of maternal health services in rural communities.
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- What is the distribution and density of health facilities providing essential maternal health services (antenatal care, skilled delivery, postnatal care) across different rural communities in Nigeria?
- What are the qualifications and availability of skilled healthcare providers (doctors, midwives, nurses) offering maternal health services in rural facilities?
- What are the traditional beliefs and practices related to pregnancy, childbirth, and postnatal care prevalent in different rural communities?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no statistical significant relationship between Maternal Health Services Accessibility and Utilization in Rural Areas in Nigeria.
1.6 Significance of the Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the Public Health sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analysed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organisations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of the Study
The study is delimited to Oron LGA, Akwa Ibom. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of the Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of the Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
REFERENCES
World Health Organization. (2016). WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization. [Link: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/]
Federal Ministry of Health Nigeria. (2019). National Strategy for the Implementation of Community Health Influencers, Promoters, and Services (CHIPS) in Nigeria. Abuja: Federal Ministry of Health Nigeria.
United Nations Children's Fund (UNICEF). (2020). Maternal and Newborn Health Disparities in Rural and Urban Nigeria. UNICEF Nigeria. [Link: https://www.unicef.org/nigeria/media/5316/file/Maternal%20and%20newborn%20health%20disparities%20in%20rural%20and%20urban%20Nigeria.pdf]
Ahmed, S., Creanga, A. A., Gillespie, D. G., & Tsui, A. O. (2010). Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS ONE, 5(6), e11190. [DOI: 10.1371/journal.pone.0011190]
Doctor, H. V., Findley, S. E., Ager, A., Cometto, G., Afenyadu, G. Y., & Adamu, F. (2015). Using community-based research to shape the design and delivery of maternal health services in Northern Nigeria. Reproductive Health Matters, 23(45), 104-118. [DOI: 10.1016/j.rhm.2015.06.005]
