School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada.
Women's Health and Action Research Centre, Benin City, Nigeria.
Fam Med Community Health. 2021 Aug;9(3). doi: 10.1136/fmch-2021-000994.
The objective of this paper is to explore policy-makers and clinical managers' views on maternal health service delivery in rural Nigeria.
This is a qualitative study using key informant interviews. Participants' responses were audio recorded and reflective field notes supplemented the transcripts. Data were further analysed with a deductive approach whereby themes were organised based on existing literature and theories on service delivery.
The study was set in Esan South East (ESE) and Etsako East (ETE), two mainly rural local government areas of Edo state, Nigeria.
The study participants consisted of 13 key informants who are policy-makers and clinical managers in ESE and ETE in Edo state. Key informants were chosen using a purposeful criterion sampling technique whereby participants were identified because they meet or exceed a specific criterion related to the subject matter.
Respondents generally depicted maternal care services in primary healthcare centres as inaccessible due to undue barriers of cost and geographic location but deemed it acceptable to women. Respondents' notion of quality of service delivery encompassed factors such as patient-provider relationships, hygienic conditions of primary healthcare centres, availability of skilled healthcare staff and infrastructural constraints.
This study revealed that while some key aspects of service delivery are inadequate in rural primary healthcare centres, there are promising policy reforms underway to address some of the issues. It is important that health officials advocate for strong policies and implementation strategies.
本文旨在探讨尼日利亚农村地区政策制定者和临床管理人员对孕产妇卫生服务提供的看法。
这是一项使用关键知情人访谈的定性研究。参与者的回答被录音，并附有反思性现场记录来补充记录。数据进一步采用演绎方法进行分析，即根据现有的服务提供文献和理论来组织主题。
该研究在埃桑东南（ESE）和埃塔科东（ETE）进行，这两个地区是尼日利亚埃多州的两个主要农村地方政府区。
研究参与者包括来自埃多州 ESE 和 ETE 的 13 名政策制定者和临床管理人员，他们是关键知情人。选择关键知情人采用的是有目的的标准抽样技术，即根据与主题相关的特定标准来确定参与者。
受访者普遍认为初级保健中心的孕产妇护理服务由于费用和地理位置的不当障碍而难以获得，但对妇女来说是可以接受的。受访者对服务提供质量的概念包括医患关系、初级保健中心的卫生条件、熟练医疗人员的可用性和基础设施限制等因素。
本研究表明，虽然农村初级保健中心的一些服务提供方面存在不足，但正在进行有希望的政策改革来解决其中的一些问题。卫生官员倡导强有力的政策和实施策略非常重要。
