Effect of a multifaceted intervention on the utilisation of primary health for maternal and child health care in rural Nigeria: a quasi-experimental study.

Autor:	Okonofua F; Women's Health and Action Research Centre, Benin City, Nigeria feokonofua@yahoo.co.uk.; Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria., Ntoimo LF; Women's Health and Action Research Centre, Benin City, Nigeria.; Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria., Yaya S; School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada.; The George Institute for Global Health, University of Oxford, Oxford, UK., Igboin B; Women's Health and Action Research Centre, Benin City, Nigeria., Solanke O; Federal Ministry of Health, Abuja, Nigeria., Ekwo C; Women's Health and Action Research Centre, Benin City, Nigeria., Johnson EAK; West African Health Organisation, Bobo-Dioulasso, Burkina Faso., Sombie I; West African Health Organisation, Bobo-Dioulasso, Burkina Faso., Imongan W; Women's Health and Action Research Centre, Benin City, Nigeria.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Feb 08; Vol. 12 (2), pp. e049499. Date of Electronic Publication: 2022 Feb 08.
DOI:	10.1136/bmjopen-2021-049499
Abstrakt:	Objective: The objective of this study was to determine the effectiveness of a set of multifaceted interventions designed to increase the access of rural women to antenatal, intrapartum, postpartum and childhood immunisation services offered in primary healthcare facilities. Design: The study was a separate sample pretest-post-test quasi-experimental research. Setting: The research was conducted in 20 communities and primary health centres in Esan South East and Etsako East Local Government Areas in Edo State in southern Nigeria PARTICIPANTS: Randomly selected sample of ever married women aged 15-45 years. Interventions: Seven community-led interventions implemented over 27 months, consisting of a community health fund, engagement of transport owners on emergency transport of pregnant women to primary health centres with the use of rapid short message service (SMS), drug revolving fund, community education, advocacy, retraining of health workers and provision of basic equipment. Primary and Secondary Outcome Measures: The outcome measures included the number of women who used the primary health centres for skilled pregnancy care and immunisation of children aged 0-23 months. Results: After adjusting for clustering and confounding variables, the odds of using the project primary healthcare centres for the four outcomes were significantly higher at endline compared with baseline: antenatal care (OR 3.87, CI 2.84 to 5.26 p<0.001), delivery care (OR 3.88, CI 2.86 to 5.26), postnatal care (OR 3.66, CI 2.58 to 5.18) and childhood immunisation (OR 2.87, CI 1.90 to 4.33). However, a few women still reported that the cost of services and gender-related issues were reasons for non-use after the intervention. Conclusion: We conclude that community-led interventions that address the specific concerns of women related to the bottlenecks they experience in accessing care in primary health centres are effective in increasing demand for skilled pregnancy and childcare in rural Nigeria. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu