Project – Assessment of the utilization of maternal health care services
CHAPTER ONE
INTRODUCTION
- Background to the Study
Maternal health care services play a vital role in reducing maternal morbidity and mortality, particularly in resource-constrained settings. The utilization of these services, which includes antenatal care (ANC), skilled birth attendance, and postnatal care (PNC), is crucial in ensuring the well-being of mothers and infants. The utilization of maternal health services at primary health care (PHC) facilities, such as Koffai Primary Health Care, can be influenced by a range of factors including socioeconomic status, geographical location, education level, and cultural practices. Studies have shown that improving access to maternal health services is directly linked to a reduction in maternal deaths (Birmeta et al., 2013). In sub-Saharan Africa, where maternal mortality rates remain high, understanding the factors that affect the utilization of PHC services is essential in designing effective interventions.
Research indicates that one of the major barriers to the utilization of maternal health services in rural areas is the lack of adequate infrastructure and transportation. In the case of Koffai Primary Health Care, many women face difficulties in accessing services due to poor road networks and long distances from their homes to health facilities. This is consistent with findings from a study by Gage (2007), which highlighted that poor physical access to health facilities is a significant determinant of low utilization of maternal health services. Women living in rural and remote areas often find it difficult to travel to health centers due to transportation costs or time constraints, which can lead to delays in seeking care and, ultimately, worse health outcomes.
Another significant barrier is the cultural and societal factors that influence health-seeking behavior. Studies have highlighted the role of cultural beliefs in shaping women’s decisions to seek maternal care. In some communities, traditional birth attendants (TBAs) are still preferred over skilled health personnel, as they are seen as more familiar and trustworthy. A study by Amankwaa et al. (2019) found that women’s perceptions of maternal health care services were influenced by factors such as the preference for traditional methods of delivery and the perceived quality of care at health facilities. In the context of Koffai, understanding these cultural perceptions and integrating them into the design of maternal health services could enhance utilization.
The quality of health care services is also a critical determinant of maternal health service utilization. Research shows that women are more likely to utilize maternal health care services if they perceive the services to be of high quality, which includes competent and friendly staff, timely care, and a clean, well-equipped facility. A study conducted by Nwizu et al. (2020) found that the quality of maternal health care was a key factor in encouraging pregnant women to attend ANC and deliver at health facilities. In rural settings like Koffai, where primary health care facilities may be under-resourced, ensuring a high standard of care can be challenging but remains essential for improving service utilization rates.
Socioeconomic factors, including income, education, and employment status, are well-documented predictors of maternal health care utilization. Women with higher educational levels are more likely to seek professional health care during pregnancy, as they have better knowledge about the importance of maternal care. A study by Olaniran and Olowokere (2019) emphasized that education plays a significant role in improving women’s health-seeking behavior. Furthermore, economic barriers such as the cost of services and the ability to take time off from work can also influence women’s decisions. In Koffai, the affordability of services, the availability of subsidies, and outreach programs could be key in addressing these socioeconomic barriers.
Finally, the role of governmental and non-governmental organizations in promoting maternal health care cannot be overstated. Interventions aimed at improving the accessibility and affordability of maternal health services can have a profound impact on service utilization. In Koffai, local government policies aimed at strengthening PHC services, such as offering free or subsidized maternal health care, have been shown to increase utilization rates. A study by Doku (2015) suggested that government-sponsored health insurance schemes and community health outreach programs significantly boost maternal health care utilization by providing financial protection and increasing awareness.
- Statement of the Problem
Maternal health remains a significant public health challenge worldwide, particularly in low- and middle-income countries, where maternal morbidity and mortality rates are disproportionately high. Despite global efforts to improve access to maternal healthcare services, many women, especially in rural areas, continue to face substantial barriers to utilizing these services. Koffai Primary Health Care (PHC) serves as a vital health facility in a rural region where maternal healthcare access is critical. However, concerns persist regarding the underutilization of available maternal health services, which could lead to preventable maternal deaths and complications. This problem needs urgent attention to ensure that women in the area can benefit from the full spectrum of care during pregnancy, childbirth, and the postpartum period.
A key challenge in Koffai is the inadequate utilization of maternal health services despite the availability of antenatal care (ANC), skilled birth attendants, and postnatal care (PNC) at the primary health care center. Evidence suggests that while these services are accessible, women in the region are not taking full advantage of them. Various factors, such as limited awareness of the importance of regular ANC visits, inadequate transportation options, and cultural practices, contribute to this low utilization rate. The problem is compounded by financial constraints, as many women in rural Koffai may not be able to afford the costs of transportation to and from the health facility, even if the services themselves are subsidized or free. Understanding the root causes of this issue is crucial for designing targeted interventions to improve maternal health outcomes.
Additionally, the quality of care offered at the Koffai PHC is a matter of concern. While the facility provides essential maternal health services, there are indications that women may perceive the care as subpar, which could discourage them from utilizing these services. These perceptions may be related to a lack of trained healthcare professionals, insufficient medical equipment, or a less-than-ideal environment for childbirth. Such factors negatively impact the trust that women have in the health facility, leading them to seek alternative care from traditional birth attendants or even delivering at home, which increases the risk of complications. If the quality of care is not addressed, maternal health outcomes will continue to be poor.
Another pressing issue is the cultural and societal barriers that affect health-seeking behavior in Koffai. In rural areas, women may face significant cultural resistance to using formal health services, especially during pregnancy and childbirth. Traditional birth practices, often guided by cultural beliefs and social norms, may be preferred over institutional care. Moreover, women may not perceive hospital-based care as safe or may fear the unfamiliar environment of a health facility. These cultural practices, combined with a lack of education on the importance of professional maternal healthcare, contribute to the underutilization of services at the PHC.
The accessibility of Koffai’s maternal healthcare services is also hindered by geographical and infrastructural barriers. Women living in remote areas of Koffai may face challenges in reaching the health center due to poor road conditions and limited transportation options. Even though the PHC center is intended to serve a wide catchment area, the inability to travel to the facility in a timely manner can prevent women from attending critical health visits. The long distance to the health center, coupled with unreliable public transportation, especially for women in the later stages of pregnancy, further exacerbates the issue. These barriers are particularly concerning during emergencies when timely access to skilled care can make the difference between life and death.
Lastly, socioeconomic factors play a pivotal role in the utilization of maternal health services at Koffai Primary Health Care. Many women in the area face financial constraints that hinder their ability to access maternal healthcare services, even when they are technically available. While maternal health care may be free or subsidized at the PHC, there are often hidden costs such as transportation, medication, and out-of-pocket expenses for supplies. Additionally, women who are economically disadvantaged may prioritize daily survival needs over preventive care, such as antenatal visits, which further limits their access to essential services. Addressing these socioeconomic barriers is essential for improving maternal health outcomes and ensuring that all women in Koffai have equal access to the necessary maternal health services.
In summary, the underutilization of maternal health services at Koffai Primary Health Care is a multifaceted issue that requires a comprehensive approach to resolve. Barriers to access, cultural beliefs, concerns about the quality of care, and socioeconomic challenges all contribute to this problem. Understanding these issues in depth and identifying the key factors that limit service utilization are critical steps toward improving maternal health in the region. Without targeted interventions to address these challenges, the health outcomes for women in Koffai will continue to be suboptimal, and the goal of reducing maternal mortality in the area will remain unachieved.
- Aim and Objectives of the Study
The aim of the study is to examine assessment of the utilization of maternal health care services at koffai primary health care Ardo-kola Taraba State. The specific objectives are:
- To determine the level of awareness among women regarding maternal health care services at Koffai Primary Health Care.
- To assess the factors influencing the utilization of maternal health care services at Koffai Primary Health Care.
- To evaluate the quality of maternal health care services provided at Koffai Primary Health Care.
- To identify barriers to accessing maternal health care services at Koffai Primary Health Care.
1.4. Research Questions
The research questions are buttressed below:
- What is the level of awareness among women regarding maternal health care services at Koffai Primary Health Care?
- What are the factors that influence the utilization of maternal health care services at Koffai Primary Health Care?
- How would you evaluate the quality of maternal health care services provided at Koffai Primary Health Care?
- What are the barriers to accessing maternal health care services at Koffai Primary Health Care?
1.5. Research Hypothesis
The hypothetical statement of the study is buttressed below:
Ho: Level of awareness among women will not affect maternal health care services
H1: Level of awareness among women will affect maternal health care services
1.6. Significance of the Study
The significance of this study lies in its potential to provide valuable insights into the factors influencing the utilization of maternal health services at Koffai Primary Health Care (PHC). Understanding these factors is crucial for improving maternal health outcomes, as this research will help identify barriers and challenges that prevent women in Koffai from fully benefiting from the available maternal health services. With maternal health being a key indicator of overall health and development, the findings of this study could directly inform health policy and interventions aimed at reducing maternal morbidity and mortality in the region. By addressing the factors that hinder access to essential maternal care, this study will contribute to the ongoing efforts to improve maternal health services in rural communities.
This study also has practical significance for health care providers at Koffai PHC. By identifying the specific barriers to service utilization, such as cultural beliefs, transportation challenges, or financial constraints, the study will provide actionable recommendations for healthcare professionals and administrators. These insights can be used to refine existing maternal health services, ensuring that they are more accessible, culturally sensitive, and effective. Furthermore, the study may suggest areas where staff training and resource allocation need to be improved, thus enhancing the overall quality of care at the health center. The findings could also guide the development of more targeted outreach programs and health education campaigns to address misconceptions and increase the uptake of maternal services.
Another key significance of this study is its potential to influence local and national health policies. The evidence generated through this research could serve as a foundation for policymakers to develop strategies that are more aligned with the unique needs of rural populations. By highlighting the challenges faced by women in accessing maternal health care, the study can advocate for policy changes that prioritize infrastructure development, such as improving transportation options and expanding access to skilled health professionals. Furthermore, it could contribute to broader national and international goals, such as achieving the Sustainable Development Goal (SDG) 3, which focuses on ensuring healthy lives and promoting well-being for all at all ages, with particular emphasis on reducing maternal mortality.
Additionally, this study holds significance in the context of broader public health research. While maternal health is a well-researched field, much of the existing literature tends to focus on urban settings or specific demographic groups, leaving rural areas like Koffai underrepresented. By focusing on a rural context, this study will fill an important gap in the literature, offering a nuanced understanding of the barriers to maternal healthcare utilization in less-developed regions. The findings will contribute to the growing body of knowledge about maternal health service utilization in rural and underserved areas, providing a valuable reference for future research and interventions.
The study also offers significant implications for community engagement and empowerment. By involving the local community in the research process and understanding their perspectives on maternal healthcare, the study has the potential to strengthen the relationship between health providers and the community. It can foster a sense of ownership and cooperation, leading to greater trust in the health services provided. Moreover, by addressing the cultural and social factors that influence health-seeking behaviors, the study can empower women in the community to make informed decisions regarding their health and that of their children. Empowering women through education and support is a key step in improving maternal health outcomes.
Lastly, the findings of this study may have wider implications for similar rural communities facing comparable challenges in accessing maternal health services. By documenting the barriers and solutions identified in Koffai, this research could provide a model for other regions grappling with similar issues. It could also stimulate the development of best practices and interventions that can be implemented in other rural or underserved areas to improve maternal health care utilization. In this way, the study will have a far-reaching impact, contributing not only to improving maternal health in Koffai but also to advancing maternal health care across rural communities globally.
1.7. Scope of the Study
The study assesses the utilization of maternal health care services at koffai primary health care Ardo-kola Taraba State. The study is limited to women in koffai primary health care Ardo-kola Taraba State.
1.8. Operational Definition of Terms
- Utilization: Utilization refers to the process of using or accessing a particular service or resource. In the context of healthcare,utilization specifically means the extent to which individuals or communities use health services. This can include seeking care, making appointments, and actively engaging with healthcare providers for medical services. In maternal health, utilization refers to a woman’s use of essential services such as antenatal care (ANC), skilled birth attendance, and postnatal care (PNC) during pregnancy, childbirth, and the postpartum period. High utilization indicates that women are actively engaging with healthcare services available to them, which is crucial for improving maternal health outcomes.
- Maternal Health Care Services: Maternal health care servicesencompass a wide range of medical and support services designed to improve the health and well-being of women before, during, and after pregnancy. These services include antenatal care (ANC), which monitors the health of the pregnant woman and her baby, skilled birth attendance during delivery to ensure safe childbirth, and postnatal care (PNC), which provides support after delivery for both the mother and the newborn. Maternal health care services also address complications such as preeclampsia, postpartum hemorrhage, and infections, aiming to reduce maternal and neonatal mortality and morbidity.
- Primary Health Care (PHC): Primary health care (PHC)is a comprehensive and accessible form of healthcare that focuses on the essential health needs of individuals and communities. It is typically the first point of contact for individuals with the healthcare system and includes services such as disease prevention, health promotion, treatment of common illnesses, maternal and child health care, and basic emergency services. PHC emphasizes equity, community involvement, and a patient-centered approach to care. It is often delivered through local health centers or clinics, with a focus on preventive care and the management of health conditions before they require more specialized treatment. In the context of maternal health, PHC centers are crucial for providing accessible and affordable antenatal, delivery, and postnatal services to women, particularly in rural or underserved areas.
Project – Assessment of the utilization of maternal health care services