Assessment of the Factors Affecting Access and Utilisation of Selected Maternal Health Care Services in Kaduna State, Nigeria

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Assessment of the Factors Affecting Access and Utilisation of Selected Maternal Health Care Services in Kaduna State, Nigeria ASSESSMENT OF THE FACTORS AFFECTING ACCESS AND UTILISATION OF SELECTED MATERNAL HEALTH CARE SERVICES IN KADUNA STATE, NIGERIA BY Simiat Bidemi ABDULKAREEM PhD/SOC.SCI./16003/2011-2012 JULY, 2018 ASSESSMENT OF THE FACTORS AFFECTING ACCESS AND UTILISATION OF SELECTED MATERNAL HEALTH CARE SERVICES IN KADUNA STATE, NIGERIA BY i Simiat Bidemi ABDULKAREEM PhD/SOC.SCI./16003/2011-2012 A THESIS SUBMITTED TO THE SCHOOL OF POSTGRADUATE STUDIES, AHMADU BELLO UNIVERSITY, ZARIA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A DOCTORATE DEGREE IN SOCIOLOGY DEPARTMENT OF SOCIOLOGY, FACULTY OF SOCIAL SCIENCES AHMADU BELLO UNIVERSITY, ZARIA JULY, 2018 ii DECLARATION I declare that the work in this dissertation entitled Factors Affecting Access and Utilisation of Selected Maternal Health Care Services in Kaduna State has been carried out by me in the Department of Sociology. The information derived from the literature has been duly acknowledged in the text and a list of references provided. No part of this dissertation was previously presented for another degree or diploma at this or any other Institution. ____________________________ ________________________ Simiat Bidemi ABDULKAREEM Date iii CERTIFICATION This dissertation entitled; “ASSESSMENT OF THE FACTORS AFFECTING ACCESS AND UTILISATION OF SELECTED MATERNAL HEALTH CARE SERVICES IN KADUNA STATE by Simiat Bidemi ABDULKAREEM meets the regulations governing the award of Doctor of Philosophy (Ph.D) degree in Sociology of Ahmadu Bello University, Zaria, and is approved for the contribution to knowledge and literary presentation. ____________________________ ________________________ Dr. Y.K. Gandu Date Chairman Supervisory Committee Department of Sociology, Faculty of Social Sciences, Ahmadu Bello University, Zaria ____________________________ ________________________ Dr. C.L. Ejembi Date Member, Supervisory Committee, Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria ____________________________ ________________________ Dr. P.E.U. Mudiare Date Member, Supervisory Committee, Department of Sociology, Faculty of Social Sciences, Ahmadu Bello University, Zaria ____________________________ ________________________ Head of Department Date (Name) ____________________________ ________________________ Prof. A.Z. Abubakar Date Dean, School of Postgraduate Studies Ahmadu Bello University, Zaria iv DEDICATION This work is dedicated to the memory of my late father, Alhaji S.B. Alashonla and my late sister Mrs. Rafiat Funke Otitoju, both of whom would have wished to witness this day in my life but could not live to. We all love you, but Almighty Allah loves you most. Adieu v ACKNOWLEDGEMENTS All praises and glory are due to Almighty Allah; the most beneficent and the most merciful for His protection and guidance, and for making it possible for me to achieve my heart’s desire today. I am most indebted to my supervisors; Dr. Y.K. Gandu, Dr. C.L. Ejembi and Dr. P.E.U. Mudiare without whom; this work would not be possible today. To you, I say thank you so much. May Almighty Allah continue to be with you in all your lives endeavours? My gratitude also goes to all the lecturers in the Department of Sociology especially Prof. B. F. Okeshola who has been intellectually supportive since my undergraduate days. To you, I say may Almighty Allah grant you your heart desires. Prof. J.E. Gyong who assisted me with my corrections. Thank you sir for your concern over my progress may Almighty God rewards you abundantly. Prof. Dunmoye who encouraged me to register for Ph.D when I did, thank you sir. Furthermore to Prof. Salau who has been my father since my Diploma in Journalism days I say thank you daddy, and to Dr. Kamorudeen Adegboyega. I also wish to express my profound gratitude to my friends, late Engn. Doctor Rekiya Suleiman, Mrs. Adenike Obasanya, Mrs. Ajala, Alhaja Taibat Muhammed, Hajia F.M. Bello, Hajia Akintola, Hajia M.K. Lawal, Hajia Medinat, Hajia Ajala, Hajia Risikat Shuaibu and all entire women’s wing of NASFAT, Zaria. I am sincerely grateful to my siblings Kola Alash, Alhaja Nafisat, Mrs. Muinat and my step children Uncle Tunde, Uncle Hafeez, Anti Remi, Lateefat Tolulope and Shola for their support and words of encouragement throughout the course of this study; especially uncle Tunde who gave me etisalat modem and always recharged it throughout the period of my study. My son Al-Bilal Oluwatobiloba, you are always appreciated thank you for understanding with me through the period of my study. To you all I say thank you and Allah bless. Finally, I will not forget to appreciate my beloved husband; Alhaji A.B. Kareem for always being there for me; for supporting me morally, financially and encouraging me any time I feel discouraged about the programme. Your contribution to my success in life cannot be quantified. Thanks a million, my love. I am also grateful to my mother Alhaja R.M. Alashonla for your prayers and words of encouragement. May Almighty Allah continue to keep you for us in good health and shower you with His Rahama. To all of you and those too numerous to be mentioned, I say thank you. May Allah bless you all. vi Table of Contents Cover page..………….…………………………………………………………….…………..i Fly leaf………..……..……………………………………………………….………………...ii Title page……………...……………………………………………………………………….iii Declaration ................................................................................................................................. iii Certification ................................................................................................................................ iv Dedication ................................................................................................................................... v Acknowledgements .................................................................................................................... vi Table of Contents ...................................................................................................................... vii Abstract .................................................................................................................................... xiv List of Abbreviations/Acronyms .............................................................................................. xvi List of Appendices ................................................................................................................. xviii CHAPTER ONE ........................................................................................................................ 1 INTRODUCTION ..................................................................................................................... 1 1.1 Background to the study ..................................................................................................... 1 1.2 Policies and Programs for Maternal Health Care in Nigeria .............................................. 6 1.3 Statement of the Research Problem .................................................................................. 12 1.4 Aim and Objectives of the Study ...................................................................................... 15 1.5 Significance of the Study .................................................................................................. 16 1.6 Scope of the Study ............................................................................................................ 17 1.7 Operational Definition of Terms ....................................................................................... 17 CHAPTER TWO..................................................................................................................... 20 LITERATURE REVIEW AND THEORETICAL FRAMEWORK.................................. 20 2.1 Conceptual Review ........................................................................................................... 20 vii 2.2 Awareness of Maternal Health Care Services Among Women ........................................ 23 2.2.1 Level of Awareness of Maternal Health Care Services among Women .......................... 23 2.3 Components of Maternal Health Care Services and there Awareness by Women of Reproductive Age Group .................................................................................................. 27 2.3.1 Antenatal Care .................................................................................................................. 27 2.3.2 Delivery Services ............................................................................................................. 34 2.3.3 Emergency Obstetric Care ............................................................................................... 40 2.3.4 Postnatal Care .................................................................................................................. 41 2.3.5 Family Planning ............................................................................................................... 47 2.3.6 Abortion Care ................................................................................................................... 53 2.4 Factors Affecting Access to Maternal Health Care Services among Women .................. 55 2.4.1 Place of Residence and Access to Maternal Health Care Services .................................. 55 2.4.2 Availability and Access to Health Care Services ............................................................. 60 2.4.3 Affordability and Access to Maternal Health Care Services
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