Mhealth and Utilization of Health Care Services in Lagos Southwest Nigeria- A Pilot Study

Background: A third of pregnant women in Nigeria do not attend Antenatal care, hence this quasi-experimental study was carried out within 500 consenting pregnant women within the 5 administrative zones of Lagos to determine the association between Mhealth services and utilization of antenatal and skilled delivery services amongst pregnant women in Lagos, Southwest Nigeria.Methods: Participants were divided into an intervention (who received voice messages) and a control arm (did not receive voice messages). Ownership of a mobile phone and willingness to participate were the selection criteria. Data was collected using a structured interviewer administered questionnaire. Analysis was by descriptive statistics with 95% CI to identify factors associated with antenatal attendance.Results: Total respondents were 488 (response rate 97.6%). One hundred and fifty-nine (63.8%) of the intervention group found the messages useful. Using the WHO 2016 ANC model, women in the intervention group had a significantly higher frequency of antenatal care attendance than the control group (p < 0.0001). There was a statistically significant difference in antenatal attendance between the intervention and the controls (p < 0.0001). There was also a significantly lower likelihood of poorly supervised (unskilled) home deliveries within the intervention arm (p=0.011). Conclusion: Mhealth was associated with an increased antenatal attendance and skilled birth attendance at delivery. This has a significant impact in reducing morbidity and mortality indices.

Impact of Covid-19 Pandemic on Anc Clinic Visits and Deliveries by Skill Birth Attendant: A Retrospective Analysis in Kaduna State

COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) was first discovered in December 2019 in Wuhan, China and later declared a pandemic on March 11, 2020 by the WHO. This study was conducted to assess the impact of COVID -19 pandemic and its attendant infection prevention of lockdown on ANC utilization and deliveries by skilled birth attendants in Kaduna State. It is a retrospective data review of 18 months data on ANC clinic visit and skill birth delivery from 1,722 health facilities. October 2019 to March 2021 data was extracted from the DHIS 2. The analysis was carried out on SPSS using One Way ANOVA. A decline of 13.5% antenatal attendance for first booking compared to pre-COVID-19 was recorded. There was a slight increase of 3.5% Post-COVID-19. There was also a reduction of 4.1% in the number of pregnant women who had the four recommended ANC visits during the COVID-19 compared to pre-COVID-19 period. However, there was a reduction of 10.2% of pregnant women returning post COVID-19 lockdown. The study revealed increased number of pregnant women that delivered during and post COVID-19. There was an increase of 2, 753 and 1,699 during and post-COVID-19, respectively. At 95% confidence interval using significance value is 0.610 (i.e., p = .610), the significance is more than 0.05. Therefore, there is no statistically significant difference in the ANC utilization and skill birth attendance before, during and after the Covid-19 pandemic. Therefore Covid-19 did not affect ANC and skill birth deliveries.

Community-physician-based versus hospital-based antenatal care: A comparison of patient satisfaction

Background: Strategies to meet the healthcare needs of pregnant women are made available throughout antenatal, intra-partum and post-natal periods. These strategies are aimed at reducing perinatal and maternal mortality amongst women who access and utilise healthcare at an early stage. Late visits with irregular antenatal attendance result in failure to adequately use antenatal interventions.Objectives: This study intended to compare and describe the level of patient satisfaction with antenatal care between two groups of women who received free antenatal care from community private physicians and public midwives.Methods: A quantitative comparative descriptive design with a Likert-scale measure was used. Sixty women, half from each group, participated in the study. Structured questionnaires with closed-ended response options were used to obtain data.Results: The midwives’ group was less satisfied with antenatal care than the physicians’ group, with the former citing long waiting times as contributing to their dissatisfaction with antenatal care.Conclusion: Addressing long waiting times improves satisfaction with antenatal care. Daily antenatal visits, rather than visits on a specific day, may reduce long waiting times as women’s visits are spread over all clinic days. Satisfaction with antenatal care has implications for access to healthcare, resulting in positive pregnancy outcomes. Agtergrond: Strategieё om in die gesondheidsorgbehoeftes van swanger vroue te voorsien, word dwarsdeur die voorgeboorte, intra-partum en nageboorte periodes beskikbaar gestel. Hierdie strategieё beoog om die perinatale en moederlike sterfstesyfers te verlaag onder vroue wie reeds op ’n vroeë stadium gesondheidsorg benut. Onreёlmatige en laat voorgeboortebesoeke lei daartoe dat voorgeboorte ingrypings nie voldoende benut word nie.Doelwitte: Hierdie studie het beoog om twee groepe vroue se vlak van tevredenheid met die gratis voorgeboortesorg wat hul by privaat praktisyns uit die gemeenskap en vroedvroue uit die openbare sektor ontvang het, te vergelyk en beskryf.Metode: ’n Kwantitatiewe vergelykende beskrywende ontwerp met ’n Likert-skaal is gebruik. Sestig vroue, die helfte van elke groep, het aan die studie deelgeneem. Gestruktureerde vraelyste met geslote-vrae opsies is gebruik om die data te verkry.Resultate: Die praktisyns se groep was meer tevrede met die voorgeboortesorg as die vroedvroue se groep, veral ten opsigte van wagtye.Gevolgtrekkings: Deur die probleem van wagtye aan te spreek, kan die tevredenheid met voorgeboortesorg verhoog word. Daaglikse voorgeboortesorgbesoeke, eerder as besoeke op spesifieke dae, kan lang wagtye verminder aangesien besoeke dan oor al die kliniekdae versprei word. Tevredenheid met voorgeboortesorg hou implikasies in vir toegang tot gesondheidsorg, wat positiewe swangerskapsuitkomste tot gevolg het.