Accessing the Effectiveness of Maternal and Child Health Programs in Nasarawa State, Nigeria
Abstract:
Despite ongoing investments in Maternal Child Health (MCH) programs, preventable maternal and child morbidity and mortality continue to be significant public health issues in Nigeria. At the subnational level, there is still little data on whether these programs produce the desired results in various implementation situations. This study used a cross-sectional mixed-methods methodology to evaluate the obstacles and enablers to MCH program implementation in Nasarawa State. Four Local Government Areas—Akwanga, Keffi, Lafia, and Obi—were used for the study. Using standardized questionnaires, quantitative data was gathered from 35 health providers and 415 women of reproductive age. Focus groups and key informant interviews with service users, facility employees, program managers, and community stakeholders were used to gather qualitative data. While qualitative data were analyzed thematically, quantitative data were analyzed descriptively. The results indicated that MCH services were used extensively. Attendance at antenatal care was 98.2%, skilled birth attendance was 96.3%, facility-based delivery was 94.0%, and child immunization coverage was 95.3%. While community knowledge was almost universal at 99.5%, 86.9% of respondents reported regularly using MCH services. Despite these successes, significant implementation obstacles were found. 42.4% identified aspects of service quality as barriers to optimal utilization and 45.7% of health professionals said there was a scarcity of workers. Implementation was further hampered by delayed funding (65.7%), logistical limitations (60.0%), infrastructure deficiencies, commodities stockouts, gaps in paperwork, and sociocultural factors. Overall, Nasarawa State's MCH programs show high service uptake and knowledge, although they are nevertheless limited by issues with the health system. Improving outcomes requires strengthening worker capacity, enhancing infrastructure, guaranteeing timely finance, and institutionalizing community-based delivery methods.References:
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