Constraints to utilization of maternal health services at the primary health care level in Nnewi, Nigeria

Abstract

Background: Ensuring universal access to quality maternal health services brings to the fore the need to determine and tackle factors that deter women from utilizing these services.
Objective: To determine the constraints to utilization of maternal health services in the primary health centres in Nnewi, Nigeria.
Methodology: This was a cross-sectional survey. Using the multi-stage sampling technique, 280 women utilizing maternal health services from four randomly selected public primary health centres in Nnewi, Nigeria, were chosen for the study. Data collection employed a mix of quantitative and qualitative methods. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 16 (2007).
Results: The mean age of the 280 respondents studied was 29.2±5.9 years; 168 (60%), 70 (25%) and 26 (9.3%) of the respondents accessed ante-natal care, post-natal care and delivery services, respectively. Eighty-four (30%) mothers were not vaccinated against tetanus for such reasons as non-availability of vaccines (28.6%), fear of side effects (25%), and lack of belief in vaccination efficacy (20.3%). Difficulties experienced before accessing the facilities were: bad state of roads (60.7%), lack of transportation (34.6%) and high transportation cost (25%). Whereas, difficulties experienced at the facilities were: lack of equipment and supplies (27.5%), lack of transportation (13.2%) and unavailability of drugs (11.1%).
Conclusion: This study found that apart from ante-natal care, other maternal health services were underutilized. Funding, good access roads, affordable transportation and appropriately integrated services would boost utilization.

Keywords: Accessibility, drugs, education, equipment, funds, transportation