Abstract
The objective of the study was to identify where delays occur when women present for antenatal care in four Nigerian referral hospitals, and to make recommendations on ways to reduce delays in the course of provision of antenatal care in the hospitals. Prospective observational study. Four Nigerian (1 tertiary and 3 secondary) Hospitals. Women who presented for antenatal care. A process mapping. The National Health Service (NHS) Institute Quality and Service Improvement Tool was used for the assessment. The time women spent in waiting and receiving antenatal care in various departments of the hospitals. Waiting and total times spent varied significantly within and between the hospitals surveyed. Mean waiting and total times spent were longest in the outpatients' departments and shortest in the Pharmacy Departments. Total time spent was an average of 237.6 minutes. χ2= 21.074; p= 0.0001. There was substantial delay in time spent to receive care by women seeking routine antenatal health services in the four secondary and tertiary care hospitals. We recommend managers in health facilities include the reduction of waiting times in the strategic plans for improving the quality of antenatal care in the hospitals. This should include the use of innovative payment systems that excludes payment at time of service delivery, adoption of a fast-track system such as pre-packing of frequently used commodities and the use of new tech informational materials for the provision of health education. The Alliance for Health Policy and Systems Research, World Health Organization, Geneva; Protocol ID A65869.
Highlights
Nigeria has one of the highest rates of maternal mortality in the world
Dairo and Owoyokun[10] in a study conducted in Ibadan, Nigeria reported that 59% of pregnant and nursing mothers affirmed long waiting time as a prominent factor inhibiting the utilization of antenatal care services
The objective of the study was to identify the sections of the referral hospitals where delays occur in the hospital system when patients present for antenatal care, and to make recommendations on ways to reduce delays in the provision of maternity care in the country
Summary
Estimates from the World Health Organization showed that 58,000 women died in 2015 in Nigeria from preventable causes which accounted for 19% of global maternal deaths.[1] One of the reasons adduced for the high maternal mortality in Nigeria is the low utilization of health facilities for maternal health care. Only 36% delivered in a health facility, while 58% had no postnatal check-up after delivery.[5] Umar, Oche and Umar,[6] reported a waiting time of more than one hour for women receiving maternity care at the teaching hospital in Sokoto, Nigeria. The results of several reviews and assessments in Nigeria suggest that a major disincentive for women not to use available antenatal, delivery and postnatal services in Nigeria is the delay they experience when they seek services in public health institutions.[8,9] Dairo and Owoyokun[10] in a study conducted in Ibadan, Nigeria reported that 59% of pregnant and nursing mothers affirmed long waiting time as a prominent factor inhibiting the utilization of antenatal care services
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