Return for prenatal care and childbirth services among Nigerian women using primary health care facilities.
Joel Ojo Aluko, Regis Rugira Marie Modeste, Oluyinka Adejumo and 1 others
PMID 31871694WHAT IT FOUND
Most Nigerian women who booked antenatal care at primary health centres did not return there to give birth.
They rated these facilities lower than other hospitals and private clinics for hygiene, staff attitude and comfort.
Key findings
01Of the women who received prenatal care at the study sites, a quarter did not return to those same facilities for childbirth.
02Women rated other healthcare facilities significantly higher than the primary health care centres on aspects like environmental hygiene, labour wards, toilets, bathrooms, building appearance and staff attitude.
03The number of babies brought for immunization at these centres was significantly higher than the number of births recorded there, indicating women come for child health but not maternity care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was institution-based, so it could not accurately capture the percentage of home deliveries occurring outside these facilities. Only PHC facilities considered 'viable' by local management were included, which may exclude the most poorly resourced centres. Participants were recruited from child welfare clinics, meaning women who did not attend for immunization were not represented. Data relied on self-reported experiences and recall of events up to six weeks prior.
Declared interests
The authors declare no competing interests.
The easy way to misread this
Do not conclude that primary health care facilities are inherently unsafe for childbirth. The study shows that women choose other facilities due to dissatisfaction with specific service aspects like hygiene and staff attitude, not necessarily because the clinical care itself is inferior, though the authors suggest the facilities require an overhaul.