FACILITY READINESS FOR MATERNAL HEALTH SERVICE DELIVERY: PROVIDERS’ PERSPECTIVES IN A SEMI-URBAN NIGERIAN COMMUNITY

Abstract

Maternal mortality remains high in Nigeria (1,047 deaths per 100,000 live births nationally; 674 per 100,000 in Edo State), and facility readiness the workforce knowledge, resources, and perceived service quality that providers themselves bring to and observe within their facilities is a key determinant of whether available services translate into safe maternal outcomes. Provider-side data on readiness for Responsible Maternal Health Service (RMHS) delivery remain scarce for semi-urban Nigerian communities. This study assessed facility readiness for RMHS delivery from the perspective of health workers in Okada, Edo State.

 A descriptive cross-sectional, mixed-methods study was conducted among all 43 eligible health workers (doctors, nurses, midwives, and community health extension workers) providing maternal health services in Okada, recruited by a census approach across the Igbinedion University Teaching Hospital (IUTH) and the Okada Primary Health Care Centre. A structured, self-administered questionnaire assessed professional knowledge of RMHS and perception of facility readiness for RMHS delivery. This was supplemented by a Key Informant Interview (KII) with the Medical Officer-in-charge of the Obstetrics and Gynaecology Department, IUTH, analysed thematically. Quantitative data were analysed descriptively using IBM SPSS version 27.0, with significance set at p < 0.05.

 Nurses formed the largest professional group (24; 55.8%). Good knowledge of RMHS was demonstrated by 40 (93.0%) of health workers, though gaps persisted for the eight-contact ANC recommendation (33; 76.7% correct) and the iron/folic acid supplementation schedule (29; 67.4% correct). Overall perception of RMHS delivery was positive (42; 97.7%; mean 3.55 ± 0.50), but only 13 (30.2%) agreed that their facility had adequate staff and resources, the lowest-rated readiness item alongside community awareness of facility-based delivery (mean 2.44). 

 Health workers in Okada are individually well-informed and favourably disposed toward RMHS, but report their facilities as inadequately staffed, resourced, and equipped to consistently deliver the care they know is required. Facility readiness, not provider knowledge, is the binding constraint on RMHS delivery quality in this setting.