DOWNLOAD THE COMPLETE PROJECT

1 Users found this project useful

Effect of Skilled Birth Attendance on Maternal Mortality among Women in Nigeria

Abstract

Maternal mortality remains a major public health challenge in Nigeria, with many maternal deaths occurring during pregnancy, childbirth, and the immediate postpartum period. A substantial proportion of these deaths are associated with preventable complications such as postpartum haemorrhage, hypertensive disorders of pregnancy, sepsis, obstructed labour, and complications arising from delayed access to appropriate obstetric care. Skilled birth attendance is an important maternal health intervention designed to ensure that childbirth is supervised by trained healthcare professionals with the competencies required to recognize complications, provide appropriate obstetric care, initiate emergency interventions, and facilitate timely referral when necessary. Despite efforts to improve maternal healthcare utilization in Nigeria, barriers such as inadequate health facilities, shortages of skilled health personnel, financial constraints, geographical inaccessibility, sociocultural factors, and weak referral systems continue to limit access to skilled birth attendance, particularly among women in underserved communities. Maternal mortality refers to the death of a woman during pregnancy or within the defined postpartum period from causes related to or aggravated by pregnancy or its management. Against this background, this study investigates the effect of skilled birth attendance on maternal mortality among women in Nigeria. The study will be anchored on the Three Delays Model, the Health Systems Framework, and Andersen's Behavioral Model of Health Services Use. The Three Delays Model explains maternal mortality through delays in deciding to seek care, delays in reaching an appropriate healthcare facility, and delays in receiving adequate care after reaching the facility. The Health Systems Framework emphasizes service delivery, health workforce, essential medical resources, health information, financing, and accessibility as important components of effective maternal healthcare. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for understanding women's use of skilled birth services. Collectively, these theoretical perspectives provide a suitable framework for explaining how skilled birth attendance may influence maternal mortality in Nigeria. The study will adopt a quantitative retrospective or cross-sectional research design, depending on the availability and quality of maternal health data. Data will be obtained from selected healthcare facilities, maternal health records, demographic and health surveys, maternal death surveillance records, and relevant national and state health information systems. A multistage sampling technique may be used where primary data are collected from selected states, local government areas, healthcare facilities, and eligible women. Skilled birth attendance will be assessed using indicators such as the proportion of births attended by skilled healthcare personnel, availability of skilled birth attendants, availability of trained midwives and doctors, 24-hour delivery services, availability of emergency obstetric care, attendance at delivery by qualified personnel, and timely referral services. Maternal mortality will be assessed using indicators such as the number of maternal deaths, maternal mortality ratio, pregnancy-related deaths, and deaths associated with complications during pregnancy, childbirth, and the postpartum period. Data analysis will involve descriptive statistics to summarize skilled birth attendance and maternal mortality patterns, while chi-square tests, correlation analysis, logistic regression, and other appropriate regression techniques will be used to examine the relationship between skilled birth attendance and maternal mortality. Where longitudinal data are available, trends in skilled birth attendance and maternal mortality will be examined over time. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that increased access to skilled birth attendance has a significant negative effect on maternal mortality among women in Nigeria. Women who give birth under the supervision of qualified healthcare professionals are expected to have a lower risk of maternal death than women who deliver without skilled attendance. Skilled birth attendants can identify complications early, provide appropriate management of obstetric emergencies, administer lifesaving interventions, and facilitate timely referral to facilities with higher levels of care. Improved availability of skilled personnel and emergency obstetric services may therefore contribute to reductions in preventable maternal deaths. Conversely, shortages of skilled health personnel, inadequate equipment and medicines, poor referral systems, geographical barriers, financial constraints, and delays in receiving emergency care may reduce the effectiveness of skilled birth attendance. The effect of skilled birth attendance may also vary according to the quality and availability of maternal health services within healthcare facilities. The study is expected to contribute to the literature on skilled birth attendance, maternal mortality, maternal healthcare utilization, reproductive health, obstetric care, health-system performance, epidemiology, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, healthcare facilities, maternal health programme managers, midwives, doctors, development partners, and policymakers regarding strategies for reducing preventable maternal deaths. The study will also provide evidence-based recommendations for expanding access to skilled birth attendants, improving the distribution and retention of qualified maternal health personnel, strengthening emergency obstetric care, improving referral systems, ensuring availability of essential medicines and equipment, reducing financial and geographical barriers to skilled delivery services, and strengthening maternal death surveillance and response systems across Nigeria.

Keywords: Skilled birth attendance, maternal mortality, Nigeria, maternal health, maternal mortality ratio, skilled birth attendants, obstetric care, emergency obstetric care, reproductive health, healthcare utilization, epidemiology, public health.