Oguntunde Olugbenga, Surajo Isa M, Dauda Dauda Sulaiman, Salihu Abdulsamad, Anas-Kolo Salma, Sinai Irit
UKaid/Nigeria MNCH2 Programme, No 20 Dawaki Road, Off Ahmadu Bellow Way, Nassarawa GRA, Kano State, Nigeria.
Palladium, 20 Port Harcourt Crescent, Off Gimbiya Street, Garki, Abuja, Nigeria.
BMC Health Serv Res. 2018 Feb 9;18(1):104. doi: 10.1186/s12913-018-2902-7.
Poor quality of health services and socio-cultural dynamics may severely limit utilization of health services. Facility health committees were established in several states in northern Nigeria to reduce these barriers. The committees were charged with mobilizing communities, improving quality of health services, and promoting utilization of maternal and child health services. This study assessed this intervention.
To obtain a comprehensive picture of facility health committees' influence on maternal and child health services, we selected 33 facilities in three states in northern Nigeria (Jigawa, Kaduna, Kano) where the intervention was active. For each of these facilities we interviewed committee members (n = 399), conducted focus group discussions with a subset of committee members (18 focus groups), interviewed facility health providers (two providers from each facility), and conducted client exit interviews (n = 501).
Facility health committees appear to have a positive influence on quality of maternal and child health services in the selected facilities. Committee members, health providers, and facility clients all agree that the committees have a tangible positive effect. The most important roles of the committees are to mobilize the community and increase demand for maternal and child health services, in a region where demand is very low. Committee activities further improve health services in many ways, including advocacy, community-facility coordination, fund raising, money donation, and problem mitigation.
Facility health committees can be invaluable in contributing to improved demand for and access to quality maternal and child health services in health facilities in northern Nigeria. They provide strong linkages between community members and the health facilities, directly work to increase demand for services, and address supply-side challenges that often limit utilization of services in health facilities. The intervention can be improved by more broadly communicating committee activities in the community, and by incentivizing facility health committee members.
卫生服务质量低下和社会文化动态可能严重限制卫生服务的利用。尼日利亚北部的几个州设立了机构卫生委员会，以减少这些障碍。这些委员会负责动员社区、提高卫生服务质量以及促进孕产妇和儿童卫生服务的利用。本研究对这一干预措施进行了评估。
为全面了解机构卫生委员会对孕产妇和儿童卫生服务的影响，我们在尼日利亚北部实施该干预措施的三个州（吉加瓦州、卡杜纳州、卡诺州）选取了33个机构。对于每个机构，我们采访了委员会成员（n = 399），与一部分委员会成员进行了焦点小组讨论（18个焦点小组），采访了机构卫生服务提供者（每个机构两名提供者），并进行了服务对象出院访谈（n = 501）。
机构卫生委员会似乎对所选机构的孕产妇和儿童卫生服务质量产生了积极影响。委员会成员、卫生服务提供者和机构服务对象都一致认为这些委员会产生了切实的积极效果。在需求非常低的地区，委员会最重要的作用是动员社区并增加对孕产妇和儿童卫生服务的需求。委员会的活动还在许多方面改善了卫生服务，包括宣传、社区与机构协调、筹资、捐款以及问题缓解。
机构卫生委员会对于提高尼日利亚北部医疗机构中孕产妇和儿童卫生服务的需求及可及性可能具有巨大价值。它们在社区成员和医疗机构之间建立了紧密联系，直接致力于增加服务需求，并应对常常限制医疗机构服务利用的供应方挑战。通过在社区更广泛地宣传委员会活动以及激励机构卫生委员会成员，可以改进这一干预措施。
