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Multicenter Study
. 2019 Jan 7;19(1):10.
doi: 10.1186/s12913-018-3819-x.

Manpower capacity and reasons for staff shortage in primary health care maternity centres in Nigeria: a mixed-methods study

Joel O Aluko  1 , Rhoda Anthea  2 , R R Marie Modeste  3
Affiliations
Multicenter Study

Manpower capacity and reasons for staff shortage in primary health care maternity centres in Nigeria: a mixed-methods study

Joel O Aluko et al. BMC Health Serv Res. .

Abstract

Background: The heart-breaking maternal and neonatal health indicators in Nigeria are not improving despite previous interventions, such as 'Health for all' and 'Millennium Development Goals. The unattained health-related goals/targets of previous interventions put the success of the new Sustainable Development Goals in doubt if the existing paradigm remains unchanged. Thus, mere branding of health policies without improving what constitutes the health system such as manpower capacity and quality as well as staff-patients ratio will be wasteful efforts. This issue of global public health concern provided an indication for describing the capacity of manpower and reasons for staff shortage in primary level of health that are providing maternity services to women and their new-borns in Nigeria.

Methods: This is an embedded mixed-methods study. Its quantitative strand collected data with the aid of a structured questionnaire from 127 health workers across the 21 purposively selected primary health care centres in five local government areas. Descriptive statistics were employed for analysis. The qualitative strand of the study collected data through in depth interviews from medical officers of health or their representatives. The tape recorded and transcribed data were thematically coded, while reporting was by direct quotes. The mixing of the data from both strands was done in the discussion section.

Results: Twenty-nine (22.8%) of the health workers were between ages 51-58; 111 (87.4%) were married, while 44 (34.6%) had worked for duration of 21-33 years in service. Evidences of incompetence were observed among the health workers. A total of 92 (72.4%) had been performing episiotomies on women in labour. Similarly, 69.8% had been repairing vaginal traumas. Nine (7.1%) knew the necessary steps of controlling postpartum vaginal bleeding, while 115 (91.3%) of them had not been trained in Life-Saving Scheme and post-abortions care.

Conclusion: The shortage of manpower, disproportional skilled/semi-skilled ratio, lack of framework for staff recruitment, staff incompetence and inappropriate childbirth practices show that women were not receiving quality maternal and neonatal cares at the maternity centres.

Keywords: Capacity; Manpower; Maternity care; Nigeria; Primary health care; Staff shortage.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Senate of University of the Western Cape, Bellville, South Africa (Case reference numbers: 13/10/23), and Oyo State Ethical Committee in Nigeria ((Case reference numbers: A3/479/576). Participants were recruited into the study after written informed consent had been obtained from each of them.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Categories of health workers who repaired vaginal lacerations and episiotomies in the PHC facilities
Fig. 2
Fig. 2
Participants’ views of effectiveness of prenatal care in their facilities
Fig. 3
Fig. 3
Categories of people health workers would allow into the delivery room
Fig. 4
Fig. 4
Factors responsible for non-use of partograph in the PHC facilities
Fig. 5
Fig. 5
Procedures adopted by the health workers in the PHC facilities during postpartum haemorrhage
Fig. 6
Fig. 6
Actions taken on prenatal women during clinic visits in the facilities
See this image and copyright information in PMC

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