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Multi-stakeholder perspectives on access, availability and utilization of emergency obstetric care services in Lagos, Nigeria: A mixed-methods study

Aduragbemi Banke-Thomas, Kikelomo Wright, Olatunji Sonoiki, Onaedo Ilozumba, Babatunde Ajayi, Olawunmi Okikiolu, Oluwarotimi Akinola
  • Aduragbemi Banke-Thomas
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; McCain Institute for International Leadership, Arizona State University, Tempe, AZ, United States | a.bankethomas@asu.edu
  • Kikelomo Wright
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos; Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
  • Olatunji Sonoiki
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
  • Onaedo Ilozumba
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos; Athena Institute, Vrije Universiteit, Amsterdam, Netherlands
  • Babatunde Ajayi
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
  • Olawunmi Okikiolu
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
  • Oluwarotimi Akinola
    Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Ikeja, Lagos; Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria

Abstract

Globally, Nigeria is the second most unsafe country to be pregnant, with Lagos, its economic nerve center having disproportionately higher maternal deaths than the national average. Emergency obstetric care (EmOC) is effective in reducing pregnancyrelated morbidities and mortalities. This mixed-methods study quantitatively assessed women’s satisfaction with EmOC received and qualitatively engaged multiple key stakeholders to better understand issues around EmOC access, availability and utilization in Lagos. Qualitative interviews revealed that regarding access, while government opined that EmOC facilities have been strategically built across Lagos, women flagged issues with difficulty in access, compounded by perceived high EmOC cost. For availability, though health workers were judged competent, they appeared insufficient, overworked and felt poorly remunerated. Infrastructure was considered inadequate and paucity of blood and blood products remained commonplace. Although pregnant women positively rated the clinical aspects of care, as confirmed by the survey, satisfaction gaps remained in the areas of service delivery, care organization and responsiveness. These areas of discordance offer insight to opportunities for improvements, which would ensure that every woman can access and use quality EmOC that is sufficiently available.

Keywords

Emergency obstetric care; access; availability; utilisation; Nigeria

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Submitted: 2017-06-01 03:21:54
Published: 2017-12-31 00:00:00
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Copyright (c) 2017 Aduragbemi Banke-Thomas, Kikelomo Wright, Olatunji Sonoiki, Onaedo Ilozumba, Babatunde Ajayi, Olawunmi Okikiolu, Oluwarotimi Akinola

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