Going to scale: design and implementation challenges of a program to increase access to skilled birth attendants in Nigeria

BMC Health Services Research
Edward OkekeObinna Onwujekwe

Abstract

The lack of availability of skilled providers in low- and middle- income countries is considered to be an important barrier to achieving reductions in maternal and child mortality. However, there is limited research on programs increasing the availability of skilled birth attendants in developing countries. We study the implementation of the Nigeria Midwives Service Scheme, a government program that recruited and deployed nearly 2,500 midwives to rural primary health care facilities across Nigeria in 2010. An outcome evaluation carried out by this team found only a modest impact on the use of antenatal care and no measurable impact on skilled birth attendance. This paper draws on perspectives of policymakers, program midwives, and community residents to understand why the program failed to have the desired impact. We conducted semi-structured interviews with federal, state and local government policy makers and with MSS midwives. We also conducted focus groups with community stakeholders including community leaders and male and female residents. Our data reveal a range of design, implementation and operational challenges ranging from insufficient buy-in by key stakeholders at state and local levels, to irregular and in some cas...Continue Reading

References

Sep 24, 2004·Health Economics·Kara HansonWilliam Hsiao
Oct 10, 2006·Lancet·Oona M R CampbellUNKNOWN Lancet Maternal Survival Series steering group
Oct 19, 2006·Lancet·Marge KoblinskyUNKNOWN Lancet Maternal Survival Series steering group
Dec 21, 2006·Health Economics·Krishna Dipankar Rao, David H Peters
Feb 15, 2007·Health Policy and Planning·Peter Kamuzora, Lucy Gilson
Jun 11, 2009·BMC Health Services Research·Timothy Powell-JacksonAnthony M Costello
Jun 8, 2010·BMC Pregnancy and Childbirth·Amy J KestertonCarine Ronsmans
Jun 27, 2014·Lancet·Caroline S E HomerLinda A Bartlett

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Citations

Aug 13, 2020·Health & Social Care in the Community·Bola Lukman SolankePeter Olasupo Ogunjuyigbe

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QSR Nvivo

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