Obstetric service availability in the primary health centres in Ogoniland six years after the United Nations Environment Program UNEP report

Abstract

Pregnant women are encouraged to give birth in healthcare facilities,  including primary health centres and to be cared for by skilled birth attendants with a view of reducing  maternal and perinatal morbidity and
mortality. Unfortunately in Nigeria including Ogoniland, evidence-based assessment of obstetric service availability in Primary Health centres has not attracted adequate attention.. The aim of this study was therefore to assess obstetric service availability in Ogoniland in the Niger Delta area of Nigeria, identify shortcomings and recommend measures to improve care. This was a descriptive longitudinal observational study whereby a stepwise multistage cluster sampling and analysis of obstetric service availability in 30 functioning Primary Health centres PHCs in the 4 Local Government areas LGAs that make up Ogoniland of Rivers State was conducted. The following were assessed, using tracer items: health infrastructures with 5 tracer items, obstetric health workforce with 15 tracer items and obstetric service utilization with 3 tracer items. There were 30 functioning Primary Health Centres in Ogoniland. The average percentage of fulfilled tracer items for health infrastructures in the 30 PHCs in Ogoniland was 74%. The corresponding values for health workforce domain was 63.34% while the average percentage of fulfilled tracer items for core obstetric workforce in the whole of Ogoniland was 47.23%. Obstetric service utilization was at a critical low level with <1-2 patients attending the antenatal clinic per day, 54-460 women attending the postnatal ward in a year and 0-12 women delivering in each of the PHCs in a year. The overall poor result of obstetric service availability in Ogoni Kingdom underscores the urgent need for improvement of its domains namely infrastructures, workforce and obstetric service utilization.

Keyword: Obstetric services, Primary Health Centres, Ogoniland, UNEP.