BRIDGING THE EVIDENCE-PRACTICE GAP IN MATERNAL AND CHILD HEALTH NURSING: DETERMINANTS OF ADHERENCE TO EVIDENCE-BASED CLINICAL GUIDELINES AND THEIR ASSOCIATION WITH MATERNAL AND NEONATAL OUTCOMES IN DELTA STATE, NIGERIA

Abstract

Background: The persistent gap between evidence generation and clinical practice remains a major challenge to improving maternal and neonatal health outcomes in low- and middle-income countries. Adherence to evidence-based clinical guidelines among maternal and child health nurses may substantially influence the quality, safety, and timeliness of care.

 Objective: This study investigated the determinants of adherence to evidence-based clinical guidelines among maternal and child health nurses in Delta State, Nigeria, and examined their association with maternal and neonatal outcomes.

 Methods: A multicentre analytical cross-sectional study was conducted among maternal and child health nurses across selected healthcare facilities in Delta State. Data were collected using a structured, validated questionnaire assessing knowledge, guideline accessibility, institutional support, workload, continuing professional development, availability of resources, and adherence behaviours. Relevant maternal and neonatal outcome indicators were obtained from clinical records. Descriptive statistics, chi-square tests, and multivariable logistic regression were employed to identify significant determinants and estimate associations between guideline adherence and clinical outcomes.

 Results: Higher adherence was associated with adequate guideline knowledge, regular professional training, accessible clinical protocols, supportive supervision, adequate staffing, and availability of essential resources. Nurses demonstrating higher guideline adherence were associated with more favourable maternal and neonatal outcomes, including reduced preventable complications and improved timely clinical interventions. Institutional support and continuing professional development emerged as important independent predictors of adherence.

Conclusion: Strengthening evidence-based practice requires integrated interventions addressing individual competencies and health-system barriers. Regular training, accessible guidelines, supportive supervision, adequate staffing, and resource availability should be prioritised to improve maternal and neonatal outcomes in Delta State.