article · Pan African Medical Journal
A maternal and neonatal health project in Gombe State, Nigeria, successfully increased facility delivery rates from 27 percent to 65 percent by supplying clinic commodities, providing free transport, and deploying trained village health workers. An evaluation of women's experiences through focus group discussions revealed a strong preference for facility births over home deliveries. Mothers valued immediate, respectful care and prioritised staff competence and attitude over healthcare worker gender. However, several barriers to facility access persisted. These obstacles included reliance on traditional birth attendants, the absence of husbands at labour onset, rapid delivery, long distances, high transport costs, staff absenteeism, and lengthy clinic waiting times. Addressing these socio-economic and clinic-level challenges remains necessary to sustain improvements in maternal healthcare utilisation.
Understanding patient experiences is essential for lowering maternal and newborn mortality in low-resource regions. While targeted interventions like community health workers and free transport clearly boost clinic attendance, persistent challenges such as facility waiting times, travel costs, and family dynamics must be addressed to ensure all mothers can access skilled, safe delivery care.
The abstract outlines an applied public health service evaluation rather than a commercial technology. The findings directly inform health authorities, non-governmental organisations, and development funders designing maternal care delivery programmes and community health worker networks. This operational model is applied and tested in the field, offering a blueprint for logistics, local transport coordination, and public health service delivery rather than proprietary products.
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Introduction: a maternal neonatal health (MNH) project implemented in Gombe State improved uptake of facility delivery services from 27% to 65%. The project supplied health commodities to health facilities, provided women with cost-free transportation, and implemented the Village Health Worker program. Village health workers are lay indigenous women trained to provide community-based maternal and newborn care and to facilitate linkage to health facilities. We explored women's experiences with facility delivery services within the context of the MNH project. Methods: qualitative data were obtained through focus group discussions with women who delivered within the last 12 months. Participants were asked questions related to their experiences with the access and use of facility delivery services. Data were organized with NVivo 12 (Pro for Windows) and analyzed using directed content analysis. Results: six focus group discussions were conducted with 58 participants. Mean age was 25.1 (± 5.3) years old. All the women preferred facility delivery over home delivery for quality care. Most women reported experiencing immediate and respectful care with facility delivery services, and healthcare workers' competence and attitude were more important than the gender of the healthcare worker. However, for some women use of facility delivery services was limited due to the use of traditional birth attendants, absent husbands at the onset of labor, imminent delivery, long distance to the facility, expensive transportation fees, healthcare worker absenteeism and long clinic wait times. Conclusion: maternal neonatal health projects should be designed to ameliorate the effects of socio-economic and facility level factors that limit use of facility delivery services.
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DOI: 10.11604/pamj.2025.51.16.43132
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