Department of Pharmacology and Therapeutics, College of Medicine, Health Policy Research Group, University of Nigeria, Enugu, 400001, Nigeria.
University of Leeds, Leeds, UK.
BMC Health Serv Res. 2023 Nov 21;23(1):1280. doi: 10.1186/s12913-023-10210-6.
The low demand for maternal and child health services is a significant factor in Nigeria's high maternal death rate. This paper explores demand and supply-side determinants at the primary healthcare level, highlighting factors affecting provision and utilization.
This qualitative study was undertaken in Anambra state, southeast Nigeria. Anambra state was purposively chosen because a maternal and child health programme had just been implemented in the state. The three-delay model was used to analyze supply and demand factors that affect MCH services and improve access to care for pregnant women/mothers and newborns/infants.
The findings show that there were problems with both the demand and supply aspects of the programme and both were interlinked. For service users, their delays were connected to the constraints on the supply side. On the demand side, the delays include poor conditions of the facilities, the roads to the facilities are inaccessible, and equipment were lacking in the facilities. These delayed the utilisation of facilities. On the supply side, the delays include the absence of security (fence, security guard), poor citing of the facilities, inadequate accommodation, no emergency transport for referrals, and lack of trained staff to man equipment. These delayed the provision of services.
Our findings show that there were problems with both the demand and supply aspects of the programme, and both were interlinked. For service users, their delays were connected to the constraints on the supply side.
母婴保健服务需求低是导致尼日利亚高产妇死亡率的一个重要因素。本文探讨了初级卫生保健层面的供需方决定因素，重点强调了影响供应和利用的因素。
本定性研究在尼日利亚东南部的阿南布拉州进行。选择阿南布拉州是因为该州刚刚实施了母婴健康方案。利用三延误模型分析了影响母婴保健服务并改善孕妇/母亲和新生儿/婴儿获得护理的供需因素。
研究结果表明，该方案在需求和供应两方面都存在问题，且两者相互关联。对于服务使用者而言，他们的延误与供应方面的限制有关。在需求方面，延误包括设施条件差、通往设施的道路无法通行以及设施缺乏设备。这些延误了设施的利用。在供应方面，延误包括缺乏安全措施（围栏、保安）、设施选址不佳、住宿条件不足、没有转诊的紧急交通工具以及缺乏能够操作设备的训练有素的工作人员。这些延误了服务的提供。
我们的研究结果表明，该方案在需求和供应两方面都存在问题，且两者相互关联。对于服务使用者而言，他们的延误与供应方面的限制有关。
