TABLE OF CONTENTS
ABSTRACT. ii
TABLE OF CONTENTS……………………………………………………….iv
CHAPTER ONE. 1
INTRODUCTION. 1
1.1 Background to the Study. 1
1.2 Statement of the Problem.. 4
1.3 Objectives of the Study. 5
1.4 Research Questions. 6
1.5 Research Hypothesis. 6
1.6 Significance of the Study. 6
1.7 Scope of the Study. 7
1.8 Limitations of the Study. 7
1.9 Organization of the Study. 8
CHAPTER TWO.. 9
REVIEW OF RELATED LITERATURE. 9
2.1 Introduction. 9
2.2 Theoretical Review.. 9
2.2.1 Empowerment Theory. 9
2.2.2 Community Health Nursing Theory. 10
2.2.3 Behavioral Change Theory. 10
2.2.4 Transcultural Nursing Theory. 11
2.3 Conceptual Review.. 11
2.3.1 Overview.. 12
2.3.2 Comprehensive Antenatal Care. 12
2.3.3 Skilled Birth Attendance. 12
2.3.4 Postnatal Care and Support 13
2.3.5 Immunization Programs. 13
2.3.6 Community Outreach and Health Education. 14
2.3.7 Prevention and Management of Infectious Diseases. 14
2.3.8 Advocacy for Policy Change. 14
2.3.9 Capacity Building and Training. 15
2.3.10........................... Research and Evidence-Based Practice. 15
2.4 Empirical Review.. 15
2.5 Summary of Literature Review.. 18
3.1 Research Design. 19
3.2 Population and Sample. 19
3.3 Data Collection Methods. 19
3.4 Data Analysis Tool: Correlation. 20
3.5 Validity of Data. 20
3.6 Reliability of Data. 21
3.7 Ethical Considerations. 21
3.8 Limitations of the Study. 22
CHAPTER FOUR. 23
DATA ANALYSIS AND INTERPRETATION. 23
4.1 Preamble. 23
4.2 Socio-Demographic Characteristics of Respondents. 23
4.3 Analysis of the Respondents’ Views on Research Question one: 27
4.4 Testing Hypothesis. 38
4.5 Discussion of Findings. 40
5.1 Summary Of Findings. 43
5.2 Conclusion. 45
5.3 Recommendations. 47
APPENDICES. 55
Appendix I: Research Questionnaire: The Role of Nurses in Promoting Maternal and Child Health in Nigeria (A Case Study of Goodlife Hospital, Uyo) 55
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
One of the major public health issues in developing nations is the elevated rates of maternal and newborn mortality (Ueno et al. 2015). Particularly impacted is Sub-Saharan Africa, where 201,000 maternal fatalities were reported in 2015 (World Health Organization [WHO], 2016). In 2013, 62% of maternal mortality globally occurred in this region (WHO, 2016; Arcosi et al., 2010).
The burden of maternal and neonatal mortality in Nigeria is disproportionately high; it accounts for over 28 percent of maternal deaths (more than 82,000 in 2020) and ranks second globally in terms of the total number of neonatal deaths (more than 270,000 in 2019) (World Health Organization [WHO], 2023; WHO, 2020). These mortality figures are particularly alarming given that Nigeria's population is less than 3% of the world's population (WHO, 2023). Given these worrying statistics, the essential role of health professionals in caring for pregnant women and their newborns is critical to ensuring the quality of maternal and child health (MCH) services.
Nurses contribute significantly to improving the health and well-being of populations by providing both psychosocial and medical care in various settings while advocating for their patients (World Health Organization [WHO], 2018; UNFPA, ICM and WHO, 2021; Ministry of Health ). , 2018). At the global level, nurses represent a significant part of the healthcare workforce tasked with providing maternal and child health (MCH) services (WHO, 2018; UNFPA et al., 2021). In the context of sub-Saharan Africa, nurses and midwives are central to the provision of essential health services and education tailored to the diverse needs of mothers, newborns and children, thereby making a significant contribution to achieving favorable health outcomes (World Health Organization [ WHO], 2018).
Research suggests that a well-supported nursing and midwifery workforce has the potential to prevent up to 83% of maternal, newborn and stillbirth deaths (Homer et al., 2018). In addition, skilled, responsive and compassionate nurses and midwives are critical to improving client engagement and continuity of care and improving the quality of services and health outcomes. Their contributions are particularly significant in decreasing preterm births, lessening maternal infections, decreasing rates of postpartum hemorrhage, enhancing breastfeeding, and preventing unnecessary C-sections (Kaur, 2020). Maternal and child health (MCH) improvements are anticipated to result from investments in the nursing workforce, which could yield returns of up to 1,600 percent (16x) (Adu-Bonsaffoh et al. 2022).
In Nigeria, nurses play a central role in providing vital maternal and child health services, which include antenatal care, postnatal care, family planning counseling and immunization initiatives. They serve as primary caregivers, educators, and advocates for mothers and children, facilitating access to quality health services and promoting healthy practices during pregnancy, birth, and early childhood. Their involvement is essential to efforts to reduce maternal and child mortality rates as they provide critical care and support across the continuum of maternal and newborn health (Uzondu & Chineke, 2019).
Nigerian nurses play a critical role in improving maternal and child health; However, they encounter a variety of challenges that hinder their efforts including: cultural barriers, a lack of necessary resources, low staffing levels, and few opportunities for professional growth. These factors may significantly limit their ability to provide comprehensive treatment and work with vulnerable populations. However, Nigerian nurses are still working to improve mother and child health outcomes by applying innovative approaches, working with other medical specialists, and devoted advocacy (Iloh et al., 2017).
In light of this, this study explores the intricate role that nurses play in advancing maternal and child health in Nigeria by drawing on a wide range of scholarly publications and reports. By understanding the challenges, they experience and the valuable role played, authorities, health system managers, and other stakeholders can design measures and provide the required resources to enhance the nursing workforce and the overall state of MCH, by extension, in the country. Moreso, with collaboration and sustained investments in medical facilities and nursing education, Nigeria has the potential to greatly enhance maternal and child health (World Health Organization, 2019).Top of Form
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1.2 Statement of the Problem
The role of nurses in promoting maternal and child health in Nigeria faces multifaceted challenges that hinder effective healthcare delivery and optimal health outcomes. One of the primary issues is the insufficient number of trained nurses, particularly in rural areas where maternal and child mortality rates are disproportionately high. Inadequate staffing levels result in increased workloads for nurses, compromising the quality and accessibility of healthcare services for pregnant women and children. Moreover, limited resources, including medical supplies, equipment, and infrastructure, further strain the ability of nurses to provide comprehensive care, exacerbating maternal and child health disparities across the country (Olugbenga-Bello & Adebimpe, 2018).
Additionally, cultural beliefs and practices present significant barriers to maternal and child healthcare utilization and uptake of preventive services. Deep-rooted cultural norms often influence decision-making regarding childbirth practices, family planning, and seeking healthcare services, leading to delays in accessing care or opting for traditional, sometimes harmful, alternatives. Furthermore, lack of awareness and education among mothers and caregivers regarding the importance of antenatal care, skilled birth attendance, and child immunization contribute to preventable maternal and child deaths. These challenges underscore the urgent need for targeted interventions and policy reforms to strengthen the role of nurses and address systemic issues impeding maternal and child health promotion in Nigeria (Uzondu & Chineke, 2019).Top of FormBottom of Form
1.3 Objectives of the Study
The main objective of the study is to examine the role of nurses in promoting maternal and child health in Nigeria. Specific objectives of the study are:
- 1. To assess the impact of nurse-led interventions on maternal health outcomes in Nigeria, such as antenatal care attendance, facility-based deliveries, and postnatal care utilization.
- 2. To explore the knowledge, attitudes, and practices of nurses regarding essential newborn care practices and their contribution to reducing neonatal mortality in Nigeria.
- To evaluate the effectiveness of community-based health education programs delivered by nurses in promoting healthy behaviors and improving child health indicators in rural Nigerian communities.
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- 1. To what extent do nurse-led interventions, such as individual counseling or group education sessions, influence the utilization of antenatal care services, facility-based deliveries, and postnatal care among pregnant women in Nigeria?
- 2. How do the knowledge, attitudes, and practices of nurses regarding essential newborn care practices affect neonatal mortality rates in Nigerian healthcare facilities?
- What is the impact of community-based health education programs delivered by nurses on key child health indicators, such as immunization coverage, nutritional status, and incidence of childhood illnesses, in rural Nigerian communities?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no statistical significant relationship between nurses and promoting maternal and child health 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 Nursing Science 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 analyzed 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 Goodlife Hospital, Uyo. 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.
