Bridging the Gap between Concept and Reality in the Nigerian Midwives Service Scheme

Download Article

Authors : Inegbenebor, Ute


Health programs are often instituted to prevent diseases and to restore or promote health. In many cases, there are gaps between anticipated and attained goals. A case in point is the Nigerian Midwives Service Scheme, where the concept of providing 24 hour coverage of the primary health centers by skilled birth attendants is currently failing to meet the desired targets in certain parts of Nigeria, predominantly the North Eastern and North Western Zones.

This is in spite of adequate funding and organization. This article discusses the barriers to effective implementation of the program and suggests that the gap between goals anticipated during program conceptualization and goals attained after program implementation can be bridged by optimizing innovative health communications to the target audience and applying social marketing techniques to health care delivery in the affected zones. This is in addition to inter-sectoral coordination and collaboration between relevant government ministries and stakeholders.


[1.]   Abimbola, S, Okoli, U, Olubajo, O, Abdullahi, M J and Pate, MA The Midwives Service Scheme in Nigeria. PLoS Med. 2012; 9(5): e1001211. doi: 10.1371/journal.pmed.1001211. PMCID: PMC3341343.

[2.]   Ajumobi, F Underage Marriage: Playing games with child’s rights. Sunday Vanguard. 45-47 accessed 29/07/2013.

[3.]   Abou Zahr, C Maternal mortality in 1995. WHO/UNICEF/UNFPA. Maternal mortality in 1995: estimates developed by WHO, UNICEF, UNFPA.WHO/RHR01.9. Geneva, World Health Organization.1997.

[4.]   Cheng, H, Kotler, P, and Lee, N. R. Building Partnerships. Social Marketing for Public Health: An Introduction. Jones and Barlett Publishers. LLC. 2009; 8.

[5.]   Cheng, H, Kotler, P, and Lee, N R Edutainment. Social Marketing for Public Health: An Introduction. Jones and Barlett Publishers. LLC.2009; 12

[6.]   Ekwempu CC The influence of antenatal care on pregnancy outcome. Tropical Journal of Obstetrics and Gynecology.1988; I: 67-71.

[7.]   Ezekwem, U Social Practices harmful to women in Nigeria. Tropical Journal of Obstetrics and Gynecology. 2002; 19 S (1): S22-25.

[8.]   Harrison K A Maternal mortality in Nigeria: the real issues. Afr. J. Reprod Health. 1997; 1(1):7–13

[9.]   Harrison, KA The influence of maternal age and parity on childbearing with special reference to primigravidae aged 15 years and under. British Journal of Obstetrics and Gynecology. 1985; 92(S5) 23-31.

[10.]      Hogan, M C, Foreman, K J, Naghavi, M., Ahn, SY Maternal Mortality for 181 Countries, 1980- 2008; a systematic analysis of progress towards Millennium Goal 5. The Lancet.2010; 375 (9726): 1609-1623.

[11.] . Nigeria records reduction in infant and maternal mortality rates. Accessed on 18/04/2014

[12.]      Inegbenebor, U. Conceptual model for the prevention of maternal mortality in Nigeria Tropical doctor. 2007; 2(37):104-106. PMID: 17540095.

[13.]      Kotler. P Satisfying Both Employees and Customers. Selling Services for Profit. Marketing Management: Analysis, Planning, Implementation, Control.. Ninth Edition. Prentice Hall of India. New Delhi. 1999; 482.

[14.]      Nylander, PPS and Adekunle, AO Antenatal care in developing countries. Hall, MH ed. Antenatal Care. Bailliere’s Clinical Obstetrics and Gynecology. London: Bailliere Tindall, 1990; 4(1):169-186.

[15.]      Osakwe , F. Maternal mortality figure not accurate, says SOGON. National Mirror. Accessed on 18/04/2014.

[16.]      Osubor, K, Fatusi, A, Chiwuzie, J Maternal Health Seeking Behavior and Associated Factors in a Rural Nigerian Community. Maternal and Child Health Journal. 2006; 10 (2); 159-169.

[17.]      Park, K. Maternal and Child health problems. Preventive Medicine in Obstetrics, Pediatrics and Geriatrics. Park’s Textbook of Preventive and Social Medicine. 19th Edition. Prem Nagar Jabalpur. M/s banarsidas Bhanot Publishers. 2007; 415-417.

[18.]      Park, K Models of health education. Communications for health Education. Park’s Textbook of Preventive and Social Medicine. 19th Edition. Prem Nagar Jabalpur. M/s banarsidas Bhanot Publishers.2007; 712-713.

[19.]      Thaddeus S, Maine D Too far to walk: maternal mortality in context. Soc Sci. Med 1994; 38(8):1091-1110. (94)90226-7

[20.]      WHO, UNICEF, UNFPA and the World Bank. Trends in maternal mortality: 1990 to 2010. 2012; Accessed on 22/08/2013.

[21.]      UNESCO High level International Round Table on Literacy “Reaching the 2015 Literacy Target: Delivering on the promise.” National Literacy Action Plan for 2012 -2015. Nigeria. 2012; Accessed on 22/08/2013.

[22.]      Yusuf, MA, Ladan, B, Idris, UA, Halilu, A Comparative Study of the State of Literacy in Nigeria and Cuba. European Scientific Journal. 2013; 9(19): ISSN: 1857 – 7881 (Print) e - ISSN 1857- 743