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By Rural Women in Ondo State, Nigeria

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By Rural Women in Ondo State, Nigeria British Journal of Education, Society & Behavioural Science 12(2): 1-9, 2016, Article no.BJESBS.18208 ISSN: 2278-0998 SCIENCEDOMAIN international www.sciencedomain.org Determinants of the Level of Utilization of Maternal Health Care Services ‘Abiye Programme’ by Rural Women in Ondo State, Nigeria O. O. Fasina 1, F. I. Wole-Alo 1* and F. L. Idowu 1 1Department of Agricultural Extension and Communication Technology, Federal University of Technology, Akure, Ondo State, Nigeria. Authors’ contributions This work was carried out in collaboration between all authors. Authors OOF and FIWA designed the study, wrote the protocol and supervised the work. Authors OOF and FLI carried out all laboratories work and performed the statistical analysis. Author OOF managed the analyses of the study. Author FLI wrote the first draft of the manuscript. Author FIWA managed the literature searches and edited the manuscript. All authors read and approved the final manuscript. Article Information DOI: 10.9734/BJESBS/2016/18208 Editor(s): (1) Manouchehr (Mitch) Mokhtari, School of Public Health, University of Maryland, College Park, USA. (2) Tyree Oredein, Health Education & Behavioral Sciences, University of Medicine and Dentistry of New Jersey, USA. (3) Madine VanderPlaat, Department of Sociology and Criminology, Saint Mary's University, Canada. (4) Chan Shen, Department of Biostatistics, University of Texas, USA. Reviewers: (1) Ryan michael f. Oducado, West Visayas State University, Philippines. (2) Anonymous, University of Malaya, Malaysia. (3) Anonymous, The American University in Cairo, Egypt. Complete Peer review History: http://sciencedomain.org/review-history/11604 Received 9th April 2015 Accepted 2nd September 2015 Original Research Article th Published 28 September 2015 ABSTRACT This study examined factors affecting the utilization of maternal health care services ‘Abiye programme’ by rural women of Ondo State, Nigeria. A multistage and purposive sampling technique was used to select one hundred and twenty women for the study. Descriptive statistics such as frequency tables, percentages and means were used to present study findings. Pearson Product Moment of Correlation (PPMC) was used to test the study hypothesis where p<.05 determined significance. Data revealed that the majority (75.0%) of the rural women were married, with mean age of 30 years, and 20.8% had adult education. Services most utilized by respondents _____________________________________________________________________________________________________ *Corresponding author: E-mail: [email protected]; Fasina et al.; BJESBS, 12(2): 1-9, 2016; Article no.BJESBS.18208 included provision of free drugs (98.0%), free medical care for children less than five years (95.8%) and free delivery i.e. the process of birthing (95.0%). PPMC revealed that ages of the respondent (r = 0.210; p ≤ 0.05) and household size (r = -0.221; p ≤0.05) were significant determinants of the level of utilization of maternal health services ‘Abiye programme’. Two major constraints faced by the respondents’ were lack of income-generating activities, and distance to the maternity centers. The study concluded that the maternal health care services were highly utilized. It is recommended that free medical care for children less than five years of age, and free medications for pregnant women should continue irrespective of the change in government. Keywords: Maternal health; abiye programme; utilization and rural women. 1. INTRODUCTION infant maternal health record [2]. Globally, Nigeria accounts for about 10% of all maternal Motherhood is often associated with ill-health deaths, and has the second highest mortality and death in developing countries, and Nigeria in rate in the world, after India. Thus, for every particular. The World Health Organization has woman that dies from pregnancy-related causes, defined maternal mortality as “the death of a 20 to 30 more will develop short- and long-term woman while pregnant or within 42 days of a damage to their reproductive organs resulting in termination of a pregnancy, irrespective of the disabilities such as obstetric fistula, pelvic duration and site of the pregnancy, from any inflammatory disease and a ruptured uterus [6]. cause related to or aggravated by the pregnancy Maternal mortality is higher in women living in or its management but not from accidental and rural areas and among poorer communities. incidental causes” [1]. The maternal mortality Between 1990 and 2013, maternal mortality ratio is the number of women who die during dropped by almost 50% [5] pregnancy and childbirth, per 100,000 live births [2]. In 2013, the maternal mortality ratio in These high morbidity and mortality rates from developing countries was 230 per 100 000 live maternal health informed the decision of the births compared to 16 per 100 000 live births in Ondo state government to implement a maternal developed countries. According to the United health care programme ‘Abiye’ in Ifedore local Nations (UN) [3] Nigeria ranks high regarding government area. The mission of the ‘Abiye’ maternal and infant mortality rates with a ratio of programme is to bring qualitative and effective 545-630 per 100,000 live births on the maternal health care services to people where they live, mortality index and 75 per 1,000 live births on work and play. The objective is to strategically the infant mortality index, this makes the country counter the four phases of delay, reach out to the the second largest contributor to the under–five targeted people and remove all barriers in and maternal mortality rate in the world [4]. There achieving safe motherhood in Ondo state. The are also large disparities within countries such as four phases of delay include: delay on the part of Nigeria between women with high and low the patients to seek care when complications income and between women living in rural and arises, delay in reaching care due to poor urban areas [5]. infrastructural support, communication challenges and transport, Delay in accessing The high rate of women and infants dying during care due to poor facilities, delay in referral care child delivery informed world leaders meeting at for “at risk cases” or emergencies [7]. the United Nations Millennium summit in 2000 which adopted seven Millennium development 1.1 Objectives of the Study goals. While infant mortality was christened Millennium Development Goals (MDG-4), maternal mortality was dubbed Millennium The objective of the study was thus to determine Development Goals (MDG-5) with the aim of the factors influencing the utilization of maternal achieving 75 per cent drop from the level of health care facilities provided by the programme maternal mortality in 2015. It was on this in Ifedore Local Government Area of Ondo State, backdrop that the World Health Organization Nigeria. Specifically, the study; (WHO), the United Nations Children’s Fund (UNICEF) and other multilateral donor agencies i. described the socioeconomic released funds to many developing nations, characteristics of respondents in the study including Nigeria, to enable them to improve their area; 2 Fasina et al.; BJESBS, 12(2): 1-9, 2016; Article no.BJESBS.18208 ii. determined the level of utilization of respondents such as age, sex, religion, marital maternal health care facilities by status, educational level, farming experience, respondents and farm size and membership of social organization. iii. identified the constraints affecting the Thus were measured as follow: respondents’ utilization of the maternal health care services. Age; was measured by asking the respondent to state their actual age in years, this was 2. METHODOLOGY measured at nominal level. The study was purposively carried out in Ifedore Religion; was measured at nominal level and Local Government Area in Ondo–State because labelled as Christianity=1, Islamic=2, traditional it was the first location for the programme religion=3 implementation. Ifedore Local Government Headquarters is in Igbara-Oke. Igbara-Oke has Marital status; was measured at nominal level an area of 295 km square and a population of and labelled single =1, married=2, divorced=3, 176,327 [8] Ifedore local government area lies Widowed=4, separated=5. within the latitude 7° 24' 0" North and longitude 5° 3' 0" East. It has nine communities which Highest Educational Level; acquisition of any include Igbara-Oke, Isarun, Ero, Irese, Ikota, formal education by the respondents was Ijare, Ipogun, Ibule and Ilara. The people of measured as either yes or no (yes-2, no-1). Ifedore Local Government Area are While educational level of the respondents was predominantly Yoruba; there is co-existence of measured in years of formal education as various dialects of the Yoruba language. They Completed tertiary school-16, attended tertiary are mostly farmers and traders. school-14, completed secondary-12, attended secondary school-10, completed primary school- 2.1 Sample Size and Sampling Technique 6 and attended primary school-2. A multi-stage sampling technique was used for Farming Experience; respondents stated actual this study. At the first stage, purposive sampling years of farming experience were measured at technique was used to select two communities interval level. (Igbara-Oke and Ijare) based on the presence of maternity centres while two communities (Ilara Farm size; respondents stated actual farm size in and Ibule) were selected based on the non- hectares was measured at interval level. presence of maternity centres. Purposive sampling was employed at the second stage to Family size/household size; actual number of select 30 women within the reproductive age of people in their family was measured at interval 15-49 years from each community. A total of 120 level. respondents were interviewed for the purpose of this study. Constraints of users of maternal health services were measured on a four point rating scale to 2.2 Measurement of Variables determine the level at which they affect the respondents. Thus: ‘Always a problem’ was 2.2.1 Dependent variables given =1, ‘Sometimes a problem’ =2, ‘Never a problem’ =3, ‘Never Affected=4. The dependent variable of the study is the level of utilization of maternal health care facilities by 3.
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