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ID Design 2012/DOOEL Skopje, Republic of Macedonia

Open Access Macedonian Journal of Medical Sciences.

https://doi.org/10.3889/oamjms.2017.075

eISSN: 1857-9655

Public Health

 

 

 

Effect of Free Maternal Health Care Program on Health-seeking Behavior of Women during Pregnancy, Intra-partum and Postpartum Periods in Cross River State of Nigeria: A Mixed Method Study


 

Betta Chimaobim Edu1*, Thomas U. Agan2, Emmanuel Monjok3, Krystyna Makowiecka1

 

1London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom; 2Department of Obstetrics and Gynecology, University of Calabar and the University of Calabar Teaching Hospital, Calabar, Nigeria; 3Departments of Family Medicine and Community Medicine, University of Calabar and the University of Calabar Teaching Hospital, Calabar, Nigeria

 

Abstract

 

 

BACKGROUND: Increasing the percentage of maternal health service utilization in health facilities, through cost-removal policy is important in reducing maternal deaths. The Cross River State Government of Nigeria introduced a cost-removal policy in 2009, under the umbrella of “PROJECT HOPE” where free maternal health services are provided. Since its inception, there has been no formal evaluation of its effectiveness. 

AIM: This study aims to evaluate the effect of the free maternal health care program on the health care-seeking behaviours of pregnant women in Cross River State, Nigeria.

METHOD: A mixed method approach (quantitative and qualitative methods) was used to describe the effect of free maternal health care intervention. The quantitative component uses data on maternal health service utilisation obtained from PROJECT HOPE and Nigeria Demographic Health Survey. The qualitative part uses Focus Group Discussions to examine women's perception of the program.

RESULTS: Results suggest weak evidence of change in maternal health care service utilization, as 95% Confidence Intervals overlap even though point estimate suggest increase in utilization. Results of quantitative data show increase in the percentage of women accessing maternal health services. This increase is greater than the population growth rate of Cross River State which is 2.9%, from 2010 to 2013. This increase is likely to be a genuine increase in maternal health care utilisation. Qualitative results showed that women perceived that there have been increases in the number of women who utilize Antenatal care, delivery and Post Partum Care at health facilities, following the removal of direct cost of maternal health services. There is urban and rural differences as well as between communities closer to health facility and those further off. Perceived barriers to utilization are indirect cost of service utilization, poor information dissemination especially in rural areas, perceived poor quality of care at facilities including drug and consumables stock-outs, geographical barriers, inadequate health work force, and poor attitude of skilled health workers and lack of trust in the health system.

CONCLUSION: Reasons for Maternal health care utilisation even under a cost-removal policy is multi-factorial. Therefore, in addition to fee-removal, the government must be committed to addressing other deterrents so as to significantly increase maternal health care service utilisation.

..................

Citation: Edu BC, Agan TU, Monjok E, Makowiecka K. Effect of Free Maternal Health Care Program on Health-seeking Behavior of Women during Pregnancy, Intrapartum and Postpartum Periods in Cross River State of Nigeria: A Mixed Method Study. Open Access Maced J Med Sci. https://doi.org/10.3889/oamjms.2017.075
Keywords: Free maternal health care service; utilisation; Cross River State; Nigeria.
*Correspondence: Dr Betta Chimaobim Edu. Formally Graduate student of London School of Hygiene and Tropical Medicine, University of London, London UK. Current Address: Primary Health Care Development Agency, Calabar, Cross River State, Nigeria, Email: bettaedu@gmail.com
Received: 18-Mar-2017; Revised: 20-Apr-2017; Accepted: 03-Jun-2017; Online first: 11-Jun-2017
Copyright: 2017 Betta Chimaobim Edu, Thomas U. Agan, Emmanuel Monjok, Krystyna Makowiecka. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Funding: This research did not receive any financial support.
Competing Interests: Publication of this paper has been supported by Roche Macedonia DOOEL Skopje.
 

 

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Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia


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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.