Evaluation Of Maternal Mortality And Perceived Challenges Among Midwives At Midwives Service Scheme Facilities In Benue State

ABSTRACT

This study evaluated the Maternal Mortality and Perceived Challenges among Midwives at

Midwives Service Scheme facilities in Benue State. The objectives of the study were to determine

the recorded number of women that delivered at these facilities before and during the

implementation of MSS between 2006 and 2014, the maternal mortality recorded in the MSS

facilities before and during the implementation of MSS (2006 to 2009 and 2010 to 2014

respectively), the causes of maternal mortality recorded in the MSS facilities before and during the

implementation of MSS (2006 to 2009 and 2010 to 2014 respectively, the perceived

administrative and environmental challenges of midwives in these MSS facilities. The research

design for the study was retrospective cross sectional evaluation and descriptive survey design.

The whole population was used for this study consisting of 64 midwives from 16 MSS facilities

across 4 local governments in Benue State due to their small number. Instruments for data

collection included the researcher’s self developed profoma for secondary data and a self

developed questionnaire to collect primary data on perceived administrative and environmental

challenges among these midwives. The records used included recorded number of women that

delivered, recorded number of maternal mortality, and causes of maternal mortality in these

facilities before and during the implementation of MSS (2006 to 2009 and 2010 to 2014

respectively). The result generated was presented in tables and figures. The responses to each

question were analyzed using descriptive statistics of mean score and standard deviation. It was

found out from the study that there were no recorded deliveries in all the 16 PHC facilities before

the implementation of MSS between 2006 and 2009., there were some records of deliveries in the

facilities during the implementation of MSS between 2010 -2014., there were no recorded

maternal deaths in all the facilities before and during the implementation of MSS (2006 to 2009

and 2010 to 2014 respectively)., there were no trained health records personnel in the facilities.,

referral of complication was adequately practiced by the midwives., the utilization of these PHC

facilities for delivery increased steadily during the period these midwives were in the facilities.

The perceived administrative challenges of these midwives included lack of remuneration/

allowances, lack of ambulance service for referral of complications, inadequate number of midwives at

service delivery points, lack of 2-way referral system/feedback from General Hospitals to MSS facilities,

lack of monitoring and evaluation system in the facility etc. The Perceived environmental challenges of

the midwives included poor residential accommodation for midwives, lack of vehicles for

transportation of midwives in the community, poor road network, lack of portable water supply,

and inadequate/lack of power supply in the communities. Conclusion was drawn that most of the

midwives left the MSS facilities by the end 2014 due to overwhelming challenges especially nonpayment

of allowances and insecurity. It was recommended that Federal Government and

NPHCDA should intensify efforts geared towards revival and sustainability of MSS for the

reduction of maternal mortality and also increase their allocation to the health sector and provide

financial and other incentives to midwives to ensure their retention in the community in order to

reduce maternal mortality.