Safe Motherhood Project Research Articles

Folklore linked to pregnancy and birth in Nigeria.

As a part of a safe motherhood project implemented in eastern Nigeria between 1992 and 1996, in-house interviews were conducted with rural women and traditional birth attendants in the seven states of eastern Nigeria. The overall project was designed to contribute toward the reduction of maternal mortality and morbidity through the involvement of community leaders and women's organizations in women's health activities in rural Nigeria. It also focused on identifying and addressing some of the underlying cultural factors in maternal mortality and morbidity in Nigeria. Findings from the interview show that women in rural eastern Nigeria still hold many folklore beliefs about pregnancy and childbirth, and some of these beliefs lead to delay in the referral of complications to hospitals.

Women's and Health-Care Providers' Views of Maternal Practices and Services in Rural Nigeria

Maternal mortality and morbidity estimates in Nigeria continue to be dramatically high largely because maternal services, especially in rural areas, are often deficient and inappropriate to women's situations. The Safe Motherhood Project in Zone A examined the pregnancy-related knowledge, attitudes, and practices of community members, and women's use of community maternal health services. Focus-group discussions and interviews confirmed a number of recent findings by other studies; they also documented extensive hostility between the two most commonly used health-care providers: traditional birth attendants and midwives. The hostility resulted in rumors, deliberate attempts to discourage women from seeking higher levels of care, and refusals to accept referrals or treat patients, which were found to be serious constraints to good maternal care in the targeted rural area.

Implementing Skilled Midwifery Services in Dhaka City Urban Area: Experience from Community Based Safe Motherhood Project, Bangladesh

In Bangladesh majority of deliveries are attended by unskilled traditional birth attendants and maternal mortality is still quite high. Global evidence suggests that most critical intervention for reduction of maternal mortality is to ensure skilled attendance at birth. The objective of this study was to explore the effect of strengthening obstetric care services through implementation of skilled Midwives at selected urban centres in terms of utilization of antenatal and delivery care in the community. A quasi experimental community trial was conducted during January 2000 to June 2003. Ten health centers were selected from the maternity care centers of urban primary health care project in Dhaka city, matched into comparable pair and assigned randomly as intervention and control centers. The intervention consisted of deployment of 10 skilled midwives in pair to provide obstetric care services in five intervention centre and the community. Essential drugs and logistics were supplied to both intervention and control centers for optimizing the function. A total of 6077 mothers having less than one year child were interviewed. There was significant improvement from baseline in the utilization of antenatal care services (6.1 vs. 2.1%, p<0.001), availing antenatal visits 5 times or more (13.4% vs. 8.1%, p<0.001), consultation with skilled health care providers for pregnancy complication (9.3% vs. 5.7 %, p<0.001), institutional delivery (7.3% vs. 4.1%, p<0.001) and delivery by skilled birth attendant (9.4% vs. 5.8%, p<0.001) between intervention and control area respectively. The intervention of deployment of skilled midwives improved utilization of ANC, increased institutional delivery and delivery by skilled birth attendants. The program can be scaled up to see its impact on maternal health. Key words: skilled midwife; emergency obstetric care; urban health care; antenatal care DOI: 10.3329/jbsp.v29i1.7165J Bangladesh Coll Phys Surg 2011; 29:10-15