Assessment of quality of maternal and newborn care and its determinants: a national study of primary health care facilities in Nigeria.

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Toluwani Oluwatola, Saheed Dipo Isiaka, Oluomachukwu Omeje, Folake Oni, Olugbemisola W Samuel, Sidney Sampson, Hilda Ebinim, Oluwadamilare Olatunji, Oluwafisayo Ayodeji, Dolapo Ajibola, Stallone Ngobua, Oluwafunmilayo Dehinbo, Helen Ukoh, Leyira Ken-Aminikpo, Segun Adenipekun, Hilary I Okagbue
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引用次数: 0

Abstract

Background: Reducing the global burden of maternal morbidity and mortality necessitates focusing on the quality of maternal and newborn care (MNC). This study aimed to assess the quality of MNCs among 25,840 public primary healthcare centers (PHCs) across Nigeria, analyze subnational variations, and determine the influence of contextual variables on the quality of care (QoC) by PHCs.

Methods: Data from a nationwide PHC assessment conducted in 2022 were utilized to create the composite index of care for PHC facilities in Nigeria. Summary statistics were then generated for the composite of care scores across PHC facilities. Subnational differences in QoC among the 36 states and the Federal Capital Territory and the influence of four contextual variables (Basic Health Care Provision Fund-status of PHC, activity of ward development committees, implementation of quality improvement plan, and activity of facility management committees) on QOC were determined using a one-way analysis of variance and multiple linear regression respectively.

Results: PHCs in Nigeria had QoC scores ranging from 0.06-4.0 and a mean QoC score of 2.07. There were significant variations in the mean PHC facility QoC across states, with Katsina and Ondo states having the lowest (1.35) and highest (2.98) QoC, respectively. The regression model showed that the contextual variables analyzed accounted for 31.5% of the variation in QoC, with varying statistically significant relationships with the QoC.

Conclusion: The quality of maternal and newborn healthcare in Nigeria's PHC facilities is unsatisfactory, with noticeable subnational variation in the QoC. To achieve significant improvements in the quality of care provided by PHC facilities in the country, targeted interventions, such as empanelment of more PHCs as BHCPF facilities, strengthening implementation of quality improvement plans and strengthening activities of ward development committees, and facility management committees, are required to improve the quality of maternal and newborn care, and reduce maternal and infant mortality rates.

孕产妇和新生儿护理质量及其决定因素评估:尼日利亚初级保健设施国家研究。
背景:减轻孕产妇发病率和死亡率的全球负担需要关注孕产妇和新生儿护理(MNC)的质量。本研究旨在评估尼日利亚25840个公共初级卫生保健中心(phc)中跨国公司的质量,分析次国家差异,并确定环境变量对初级卫生保健中心护理质量(QoC)的影响。方法:利用2022年进行的全国初级保健评估的数据,创建尼日利亚初级保健设施护理的综合指数。然后对初级保健设施的综合护理评分进行汇总统计。采用单向方差分析和多元线性回归,分别确定了36个州和联邦首都直辖区在国家范围内的QoC差异,以及四个背景变量(基本医疗保健提供基金-初级保健的状况、病房发展委员会的活动、质量改进计划的实施和设施管理委员会的活动)对QoC的影响。结果:尼日利亚PHCs的质量分数为0.06-4.0,平均质量分数为2.07。各州的平均初级保健设施质量分数存在显著差异,卡齐纳州和翁多州的质量分数分别最低(1.35)和最高(2.98)。回归模型显示,所分析的上下文变量占QoC变化的31.5%,与QoC的关系具有不同的统计学意义。结论:尼日利亚初级保健机构的孕产妇和新生儿保健质量令人不满意,在质量指标方面存在明显的地方差异。为了显著改善国内初级保健设施提供的护理质量,需要采取有针对性的干预措施,例如将更多初级保健设施纳入初级保健和儿童保健基金设施,加强执行质量改进计划,加强病房发展委员会和设施管理委员会的活动,以提高孕产妇和新生儿护理的质量,并降低孕产妇和婴儿死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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