1.1 Introduction
Maternal and child health services in health systems constitute a large range of curative and preventative health services of particular importance to the health of women of reproductive age. Assessing the level of utilization of childbirth care services is important to know whether women who are determined to deliver in such facilities do not eventually get discouraged due to the factors affecting utilization including accessibility. Maternal Health Service utilization and, understanding the associated factors are particularly important in order to reduce the existing gaps among regions and improve the quality of health services delivered to pregnant mothers towards reducing the maternal morbidity and mortality that are related to pregnancy and childbirth.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
A maternal and reproductive health service refers to population-based services such as behavior change and health communication. It includes a range of services provided to women of reproductive age prior to conception, during pregnancy, during and after delivery (Lule et al., 2012). Its importance particularly in developing countries cannot be overemphasized. For instance, antenatal care (ANC) helps to ensure the well-being of the mother and fetus through early detection of risks in pregnancy, prevention of pregnancy and labor complications and ensures the safe delivery of mother and child. Furthermore, it exposes pregnant women to counseling and education about their own health and the care of their children. With the strong positive association that has been shown to exist between level of care obtained during pregnancy and the use of safe delivery care, ANC also stands to contribute indirectly to maternal mortality reduction (Babalola et al., 2009). However, vast majority of women in Sub‑Saharan Africa do not have access to safe delivery care (Boschi-Pinto et al., 2009).
However, pregnant woman enjoys these benefits when she attends ANC and delivers in appropriate health facility. In addition, pregnancy must be supervised by a trained health personnel and labor attended to by a skilled birth attendant (WHO et al., 2012). Furthermore, the woman on her part is expected to book early and attend adequate number of ANC prior to delivery. Although ANC attendance has been measured based on the proportion of women who have attended ANC at least once during pregnancy; World Health Organization (WHO) in 2002 recommends that pregnant women should attend ANC at least 4 times starting from the first trimester (WHO et al., 2013).
In Nigeria, the current ANC schedule recommends that a pregnant should book for ANC during the first trimester, thereafter attend ANC clinic as follows; 4 weekly until 28 weeks gestation, 2 weekly until 36 weeks gestation and weekly until delivery. Evidence available suggests that most women who attend ANC in the country do not receive adequate attention and care providers are overwhelmed by the number of pregnant women seeking ante natal care. Consequently, some advocates have argued for the adoption of focused ANC care, in which case a woman attends ANC 4 times during pregnancy at specific intervals as recommended by WHO. This allows for adequate attention to be given to each pregnant woman while high-risk pregnancies are better monitored (Villar et al., 2002).
Major challenges in the World today remain the health of women and children (Filippi et al., 2006). Improving maternal health is one of the targets of the third Sustainable Development Goals (SDGs) adopted by the international community (Alkema et al., 2016). Half a million women globally, are estimated to die each year from pregnancy and childbirth. Greater than half of maternal and child deaths occur in Africa (WHO et al., 2016). Most of these deaths are caused by complications during or just after delivery and the vast majority of the complications are avoidable (Filippi et al., 2006).
Therefore, in Enugu State where the research was carried out, the activities that was conducted is to evaluate the Maternal and Child Health Care Quality Services.
1.3 Statement of Problems
Investigation revealed that despite these efforts, maternal morbidity and mortality remain a major public health problem in the country. Recently, the country rolled out the integrated maternal, newborn and child health (IMNCH) strategy as part of measures aimed at reducing maternal and infant mortality and the attainment of millennium development goals (MDGs) four and five. This was informed by the fact that significant progress has not been made toward reduction of maternal mortality and under-five deaths.
1.4 Aim and Objectives of Study
The aim of the study is to evaluate the Maternal and Child Health Care Quality Services in Enugu Primary Health Care Facility. In achieving this aim, the following specific objectives were laid out as follows:
- To explore the pattern of maternal and child health care services utilization
- To determine the socio-demographic factors influencing the maternal and child health care services
- To assess the utilization of Maternal Health Services and its determinants among mothers attending Enugu PHC
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are there socio-demographic factors influencing the maternal and child health care services?
- What is the pattern of maternal and child health care services utilization?
- What is the utilization of Maternal Health Services and its determinants among mothers attending Enugu PHC?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There are no significant socio-demographic factors affecting the maternal and child health care service delivery in Enugu Primary Health Care Facility
- H1: There are significant socio-demographic factors affecting the maternal and child health care service delivery in Enugu Primary Health Care Facility
1.7 Significance of Study
The relevance of this study is the quality of care from the pregnant women and mothers perspective that reflected in patient’s satisfaction. This study will be of immense benefit to academic students and other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Evaluation of Maternal and Child Health Care Quality Services in Enugu State Primary Health Care Facility.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
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