ASSESSMENT OF QUALITY OF MATERNAL AND NEWBORN CARE AND ITS DETERMINANTS IN PRIMARY HEALTH CARE FACILITIES IN NIGERIA: IMPLICATIONS FOR SERVICE DELIVERY IMPROVEMENT

Abstract

 Background: Ensuring high-quality maternal and newborn care in primary health care (PHC) facilities remains fundamental to reducing preventable maternal and neonatal morbidity and mortality in Nigeria. Despite sustained policy interventions, considerable disparities persist in the quality of care delivered across PHC settings, thereby undermining progress toward universal health coverage and Sustainable Development Goal 3.

Objective: This study assessed the quality of maternal and newborn care and identified the key determinants influencing service delivery in primary health care facilities in Nigeria.

Methods: A cross-sectional analytical design was employed among healthcare providers and postpartum women selected through multistage sampling. Data were collected using standardized, validated questionnaires and facility assessment checklists based on national maternal and newborn care quality standards. Descriptive statistics summarized participant characteristics and quality indicators, while chi-square tests and multivariable logistic regression identified significant determinants of quality care at a 5% significance level.

 Results: The findings demonstrated considerable variations in the quality of maternal and newborn care across PHC facilities. Availability of skilled healthcare personnel, essential medicines and equipment, continuous professional training, supportive supervision, adherence to clinical guidelines, and adequate infrastructure were significant predictors of high-quality service delivery. Facilities with stronger organizational support consistently achieved better maternal and newborn care outcomes than poorly resourced facilities.

 Conclusion: Strengthening workforce capacity, improving infrastructure, ensuring uninterrupted availability of essential commodities, and institutionalizing continuous quality improvement strategies are critical for enhancing maternal and newborn care in Nigerian PHC facilities. These interventions will improve service delivery, patient outcomes, and health system resilience while accelerating progress toward national and global maternal and newborn health targets.