Identifying Barriers to Utilization of Basic Emergency Obstetric and NewBorn Care Services in Jigawa State, North-western Nigeria: A Qualitative Study

Abstract

Background: Maternal mortality has remained high in northern Nigeria despite decades of effort aimed at reducing it. The number of  women who deliver in Emergency Obstetric Care (EmONC) facilities is low. This study explored the barriers to utilizing Basic EmONC  services in Jigawa State. Methods: A qualitative study was conducted among mothers of children under five years through 12 Focus  Group Discussions. A purposive sampling technique was used to select participants who were categorized based on age (below 35 years,  35 years and above) and prior utilization of EmONC services. Content analysis along thematic lines was done and the findings were  reported in narrative form. Results: The mean age of participants was 31 ± 6 years. The majority of participants had primary education  and most were unemployed. Most of the participants identified obstetric danger signs, however, they opine that medical attention should be sought only when complications become serious. Participants in all groups unanimously said decision-making for seeking medical  care rests with the husband and occasionally the mother-in-law. Barriers to seeking care identified by participants include lack of money,  distance to the nearest health facility, fear of embarrassment by healthcare workers, and insecurity among others. Conclusion: Most  participants were knowledgeable of obstetric danger signs, but with low risk-perception towards obstetric complications. The Jigawa  State government should engage in a robust education campaign on the need for early decision-making to seek care as well as  strengthen its women empowerment programs to overcome barriers to seeking care for obstetric complications.