Premium
Impact assessment of a maternal health project in a megacity, Nigeria: toward a future with more demand for maternal health services
Author(s) -
Matsuoka Sadatoshi,
Koga Sumiko,
Suzui Emiko,
Tsukada Yoshiko,
Ohashi Kazutomo,
Johnson Taiwo
Publication year - 2016
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2354
Subject(s) - psychological intervention , scrutiny , medicine , public health , program evaluation , maternal health , service (business) , test (biology) , environmental health , quality (philosophy) , business , health services , nursing , medical education , political science , population , marketing , public administration , paleontology , philosophy , epistemology , law , biology
Summary To improve the quantity and quality of maternal health services in Lagos State, Nigeria having a maternal mortality ratio of 555 per 100 000 live births, a four‐year project was implemented since February 2010. The major activity of the project was training for both the service supply and demand sides. This study aimed to examine the impact of the project on coverages and quality of the services in target areas, and guide statewide policies. The Cochran–Armitage test for trend was applied to understand trends in the service coverages during 2009–2013. The same test was performed to analyse trends in the proportions of perineal conditions (i.e. intact or tear) and to evaluate variations in midwives' snkill during 2011–2013. The paired t ‐test was used to analyse changes in midwives' knowledge. The project interventions contributed to a significant increase in the overall service coverages, including improvements in midwifery knowledge and possibly in their skills. However, the service coverage was still limited as of the termination of the project. To instal the interventions and maximise the effect of them state‐wide, it is recommended to undertake five tasks: (i) establishment of public primary health centres offering 24‐h maternal health services; (ii) redeployment and recruitment of public health personnel; (iii) expansion of midwifery trainings and continuous education by the local trainers; (iv) review of grass‐roots level activities; and (v) scrutiny of barriers to maternal health services. Copyright © 2016 John Wiley & Sons, Ltd.