PERCEPTIONS ON QUALITY OF MATERNAL HEALTH CARE SERVICE AND MATERNAL MORTALITY IN KADUNA NORTH LOCAL GOVERNMENT AREA OF KADUNA STATE

                                                                            ABSTRACT

Maternal mortality continues to be the major cause of death among women of reproductive age in many countries and remains a serious public health issue especially in developing countries. Nigeria presently has one of the highest rates of maternal mortality in the developing world. Indeed, the country has been ranked as the number two country (after India) with the highest absolute numbers of maternal deaths in the world. Pregnancy and childbirth is a normal physiological process bringing a joyful experience to individuals and families. However, in many parts of the world, pregnancy and childbirth is a perilous journey, a risky and potentially fatal experience for millions of women especially in developing countries. This is in spite of evidence which shows that motherhood can be safer for all women. Quality health care service requires that necessary health related services are applied to safeguard mother and child health, and their satisfaction with care is achieved. However, the essential and enabling factors to guarantee quality health care service are limited or lacking in Nigeria. The need for quality maternal health care service is crucial as it is inextricably linked between maternal survival and newborn. Thus the poor quality of health care pregnant women receive along the various level of care, has worsened the problem of maternal and child health in Nigerian communities. The participants were one hundred and twenty-five (125) respondents. This study looks at perceptions on quality of health care services and maternal mortality in Kaduna North Local Government of Kaduna State. The study adopted multi-stage sampling techniques using Cluster sampling method, simple random and systematic sampling techniques for the study. The results show that 24 hours healthcare services is available for pregnant women, these women mostly visit government hospitals to access these services. However, there are others who are unable to access antenatal services due to the financial charges that apply in these hospitals, healthcare providers usually are nice to them by listening and answering their questions, and others reported experiencing unfavourable attitudes such as scolding, shouting, insults and slapping of women during delivery. Traditional birth attendants contribute to maternal deaths by providing substandard care. Lack of necessary equipments and drugs, poor enable environment, lack of motivation, insufficient skills and the far distant from the place of work of healthcare providers are challenges faced by maternal healthcare provider.  Based on the finding it was recommended that health personnel should desist from harassing their patients and show more concern, government should assist by providing skilled health professionals, improving healthcare facilities and promoting awareness of the importance of antenatal care. Health workers must be trained and provided the wherewithal for optimal practice; government and community leaders should inform, educate and sensitize people on maternal health through the mass media. Increased funding of the health sector is absolutely essential.

                                                                         TABLE OF CONTENTS

CHAPTER ONE

1.0   INTRODUCTION
1.1 Background of the study   .....................................................................1
1.2Statement of research problem    ……………………………….......……...4
1.3Research question………………………………………………....……….6
1.4 Research objectives  …………………………………………….....…...….7       
1.5Significance of the study    …………………..........…………………………..7
1.6 Scope of the study             ………………….........…………………………..8
1.7 Conceptual Clarification   ………….............................……...………………………….............. 8

CHAPTER TWO
LITERATURE REVIEW AND THEORETICAL FRAMEWORK
2.1Introduction    ……………………………….........…………………………..9
 2.2Public  perception  of  thequality  of  health  care…..…...............……………....9
2.3 Public perception of maternal mortality          ………..........……………………...16
2.4 The challenges faced by maternal health care providers...........................………..23
2.5Theoretical Framework      …………………..............…………………………24
2.5.1 Political Economy Perspective----------------------------------------------------24

CHAPTER THREE
Research Methodology
3.1 Location of the study         ……………...…………………….……………….30
3.2 Source of data collection   ………………………………...…………................................31
3.3Sample size and Sample method ……………………..................................…………….........31
3.4 Method of data collection.  ……………..........………………………………33
3.5 Method of data  analysis    ……...........………………………….………...... 34
3.6 Problems encountered from the field     ……................……………………….... 35

CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
4.1 Introduction   …………………………........………………………………37
4.2 Socio- demographic characteristics of respondents……..........…...……..37
4.3 Public perception on the quality of health care          ..............................................................40
4.4 Public perception of the maternal mortality   ……,...........….…………..…48
4.5 The challenges faced by maternal health care provide….…….......................................………57

CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1 Summary of findings         ..........................................................................61
5.2Discussion of major findings       …............…………………………………63
5.3 Conclusion     ……………………….......…………………………………69
5.4 Recommendations   ……………………………….........…………………70




REFERENCES    ………………………………….........………………………73
Appendix I:              Questionnaire       ……………............……………………… 82
Appendix II In-depth Interview Guide                  ……….................………………87