Skilled Attendance: The Key Challenges to Progress in Achieving MDG-5 in North Central Nigeria

Abstract

The importance of skilled attendance at delivery, as reflected in the MDG 5, is being promoted in developing countries to address the high  maternal/perinatal morbidity and mortality. Evaluation of personnel skills and availability of material resources are central to elimination of barriers to delivery of basic Emergency Obstetric Care (EOC) to the community. We designed a semi-structured, interviewee-administered questionnaire for 54 certified Nurse-Midwives working in Primary Health Care (PHC) clinics in Nasarawa State, central Nigeria, and examined their knowledge and  competencies in the five major areas responsible for maternal mortality in sub-Saharan Africa, including power supply, referral linkages and  motivation to work. Majority 51 (94.4%) of PHCs neither used the  Partograph nor performed manual vacuum aspiration. Referral systems and feedback mechanisms were practically non-existent, 38 (70.4%) of facilities were >5km from the nearest referral centre, with 14(29.5%) connected to the national grid. Majority (68.5%) of respondents would want to work abroad. The quality of skilled attendance is low and basic EOC facilities are lacking, a situation further threatened by potential emigration to greener pastures. Governments and development partners need to address facility and skilled manpower shortages in developing countries to make a modest attempt at meeting the MDG on maternal health (Afr. J. Reprod. Health 2010; 14[2]: 129-138).

KEYWORDS: Skill attendance, maternal mortality, midwifery skills, MDGs, Nigeria.