Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria; and Health Policy and Systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria.
National Agency for the Control of AIDS, Abuja, Nigeria.
Int J Health Policy Manag. 2014 Sep 25;3(5):283-7. doi: 10.15171/ijhpm.2014.91. eCollection 2014 Oct.
In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government's FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers' groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities' health.
在尼日利亚，政府正在实施免费母婴保健计划（FMCHCP）。该政策的前提是，经济障碍是公平获得和使用熟练母婴保健服务的最重要制约因素之一。在尼日利亚东南部的埃邦伊州，FMCHCP 面临着实施挑战，包括：卫生人力资源不足、资金不足、缺货综合征、基础设施不足和员工薪酬低。此外，该计划在实施过程中对社区参与的重视程度较低。在这份政策简报中，我们建议采取政策选择，强调实施基于社区的参与式干预措施，以加强政府的 FMCHCP，具体如下：
培训社区妇女进行产前护理、紧急情况下的救生技能、生殖健康、新生儿护理和计划生育。
使社区妇女对行为改变保持敏感，了解满足其需求的优质服务，同时寻求和要求提供此类服务。
实施一揽子计划，为育龄妇女以及母亲团体和传统助产妇提供技术技能，以改善家庭母婴保健。
在一些基于社区的参与式干预措施的基础上，推广这一方法，即如果社区成员参与决策，并将当地知识、经验和问题摆在首位，他们更有可能拥有和维持解决方案，以改善其社区的健康。
这种方法的有效性已经在一些基于社区的参与式干预措施中得到了证明。
