The Challenges of Maternal Health Services Utilization and Prevention of Maternal Mortality in Northern Nigeria: Community’s Perspective in Zamfara State

Abstract

Background: The north-western part of Nigeria has the lowest maternal health services utilization according to the Nigeria Demographic and Health Survey (2013) with only about 34% of the women attending antenatal care clinic (ANC) and less than 10% delivering at the hospital or under a skilled birth attendant. There are several factors that militate against the utilization and uptake of maternal health services in northern Nigeria thus leading to increased risks of maternal deaths. The study was to identify some of the socio-cultural factors, practices and perception limiting the utilization and uptake of maternal health services in some selected communities of Zamfara State, northwestern Nigeria.
Materials and Method: The study was qualitative research involving in-depth interviews (IDIs) with a purposive sample of some community leaders, health practitioners, and focus groups discussion (FGDs) with men and pregnant women in some selected communities in Gusau local government area of Zamfara state. Six FGDs were conducted with six different groups of men and pregnant women and ten (10) in-depth interviews. All sessions were conducted in Hausa language and tape recorded, notes taken. Both FGDs and IDs were transcribed, translated and coded. Themes were developed and analysis conducted based on thematic content.
Results: The study found that some of the challenges for the utilization and uptake of maternal health services include ignorance, low level of women power in making decision, poverty, and negative attitude of health workers, delay at the clinic, distance to health facility and other cultural beliefs.
Conclusion: Socio-cultural factors, beliefs and practices are the challenges to the uptake maternal health services in communities of Zamfara state, which may increase the risks for maternal deaths among pregnant women. Thus, there is the need to encourage attendance of antenatal care visits and good health care seeking behaviour.