ABSTRACT
The importance of skilled birth attendants in the reduction of maternal and newborn morbidity and mortality worldwide cannot be over-emphasized. The midwives service scheme was established by the National Primary Health Care Development Agency (NPHCDA) in collaboration with the Nursing and Midwifery Council of Nigeria in 2009 to achieve reduction in maternal, newborn and under-five mortality in Nigeria, especially in rural communities. The purpose of the study was to determine how mothers and midwives in selected Area Councils in Abuja perceive the midwives service scheme. Five objectives and three null hypotheses were raised to guide the study. Quantitative descriptive survey design was used to study the midwives’ perception while both quantitative and qualitative methods were adopted for the study of mothers’ perception. The whole MSS midwives (32) in the studied Area Councils were used for the study while a sample size of 381 mothers was drawn from the population of 1483. Two sets of researcher-developed questionnaires were used to generate data from the midwives and mothers; while eight focus group discussion sessions with 83 mothers were also used as a back-up instrument for generating data from the mothers. The instruments were certified valid and reliable, r = 0.85 and 0.89 using split half reliability test for midwives’ and mother’s questionnaire respectively. Data were administered directly to respondents by the researcher and four assistants. Objectives of the study were analysed descriptively, while one-way ANOVA and paired t-test were used to test the hypotheses at 0.05 level of significance using the Statistical Package for Social Sciences (SPSS). Data from the focus group discussion were analyzed thematically and findings from thematic analysis wereused to back up the findings from statistical analysis. Result showed that midwives and mothers perceived the MSS positively but factors like poor salary, lack of materials like drugs, electricity and poor attitude of health workers counted negatively against the scheme. More midwives should be recruited and the midwives’ salaries enhanced to motivate them.
CHAPTER ONE
INTRODUCTION
Background to the study
Pregnancy and childbirth are normal physiological processes that bring joyful experiences to individuals and families. However, in many parts of the world, pregnancy constitutes a perilous journey, a risky and potentially fatal experience for millions of women especially in developing countries. Over 289,000 women die annually from complications during pregnancy, childbirth, or postpartum period (World Fact book, 2014 andWHO,UNICEF,UNFPA &The World Bank 2014). About 70% of these deaths are largely treatable or at least preventable (UNICEF, 2010) and nearly all these deaths (over 90%) occur in developingcountries where fertility rates are higher and a woman’s life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries (Audu, Takai, &Bukar, 2010).
The situation in Nigeria is especially grave as maternal mortality rateas high as630 per 100,000 live births is still recorded (World Health Organization, UNICEF & The World Bank, 2014), thus including Nigeria among the nations with the highest number of maternal deaths (WHO, 2010, National Primary Healthcare Development Agency (NPHCDA) 2009). Nigeria makes up only 1% of the total world population but accounts for about 10% of the global estimate for maternal mortality (FMOH & NPHCDA, 2010). The new-born and under-five mortality rates follow the same trend with an estimated infant mortality rate of 74/1,000 (Index Mundi, 2014).This ugly trend has been traced to deliveries being attended to by unskilled birth attendants (N&MCN Newsletter 2011 & NPHCDA, 2009).
It is against this backdrop that the Midwives Service Scheme [MSS] was initiated in 2003 by the Nursing and Midwifery Council of Nigeria (N&MCN) though originally as a mandatory service
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