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Utilization Of Donabedian Model In Evaluation Of Maternal And Child Healthcare Quality Service
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However, various intervention reports have documented mixed findings of
the successes and challenges as well as threats to the attainment of
quality maternal and child health care in Nigeria. It has been observed
that Nigeria is lagging behind in meeting MDG 4 and according to the
United Nations mortality estimates, Nigeria has only achieved an average
of 1.2% annual reduction in under-five mortality since 1990. And in
order to meet MDG 4, Nigeria needed to have achieved an annual reduction
rate of 10% in the five years leading to 2015 (Rajaratnam , Marcus ,
Flaxman , Wang , Levin-Rector , Dwyer , et al 2010).
Therefore,
improving and ensuring quality of health care services in health
facilities, developing strategies for quality serve as an integral
component of scaling up interventions to improve health outcomes of
mothers, newborns and children is of utmost importance (WHO, 2013).
1.2 Statement of the Problem
The
quality of care received during pregnancy and the place of delivery are
great determinants of maternal and child morbidity and mortality
(United States Agency for International Development (USAID),
2013).Worldwide significant number of women and girls yearly (almost
half a million) die as a result of complications during conception,
delivery or 6 weeks post childbirth. Majority of these deaths happen in
underdeveloped nations (United Nations Millennium Development Goals,
2009). The risk of death from conception and delivery is in Nigeria is 1
in 13, many of these deaths could have been averted with good coverage
and quality maternal and child health care (United Nations International
Children Fund (UNICEF), 2014).
Increased mothers and newborn death
and morbidity has been linked to poor quality of healthcare services
(USAID, 2013), and has been evident by increased death rates that
inadequate availability of reproductive health services is an important
challenge in Nigeria (WHO Nigeria, 2014). Although progress has been
made in increasing the coverage of several key reproductive, maternal,
newborn and child health interventions over the past two decades, there
has been limited progress in improving maternal and paediatric outcomes
because of a major gap between coverage and the quality of care provided
in health facilities (WHO, UNICEF, 2014).
Also, it has been observed
from clinical practice that there are still many cases of preventable
pregnancy and delivery complications reporting in the teaching hospital
in Ile-Ife on daily bases in spite of many healthcare facilities in the
area. Improving the quality of facility-based health care services and
making quality an integral component of scaling up interventions to
improve health outcomes of mothers, newborns and children is of utmost
importance (WHO, 2013).
Hence, the need to evaluate the maternal and
child healthcare services in healthcare facilities in Ile-Ife for
quality care to achieve Sustainable Development Goal 3 (SDG 3) which is
good health and well-being.
1.3 Objective of the Study
The main
objective of this study is to evaluate the Quality of Maternal and Child
Healthcare Services in selected Healthcare Facilities Ile-Ife utilizing
Donabedian model for Quality care
The specific objectives are to:
1.
assess the structure of maternal and child healthcare services in
Primary and Secondary health facilities in Ile-Ife based on Donabedian
model;
2. determine the process of maternal and child healthcare
services in Primary and Secondary health facilities in Ile-Ife based on
Donabedian model;
3. assess the client’s satisfaction
(outcome) with the maternal and child healthcare services in primary and
secondary health facilities in Ile-Ife based on Donabedian model for
quality care and
4. determine the categories of staff rendering
maternal and child healthcare services in primary and secondary health
facilities in Ile-Ife.
1.4 Research Questions
The following research questions were answered by the study:
1. What is the structure of maternal and child healthcare services in selected health facilities in Ile-Ife?
2. What is the process of maternal and child healthcare services in selected health facilities in Ile-Ife?
3.
What is the level of client’s satisfaction (outcome) with maternal and
child healthcare services rendered in Primary and secondary health
facilities in Ile-Ife?
4. What categories of staff are rendering maternal and child healthcare services in health facilities in Ile-Ife?
1.5 Hypotheses
The following hypothesis were tested at 0.05 level of significance.
HO1: There is no significant difference between the structure of Maternal and Child
Healthcare services in Primary and secondary health facilities in Ile-Ife.
HO2: There is no significant difference between the process of Maternal and Child Healthcare
Services in Primary and secondary health facilities.
HO3: There is no significant difference between the client’s satisfactions (outcome) with
Maternal and Child healthcare services in Primary and Secondary health facilities in Ile-
Ife.
1.6 Scope of the Study
The
scope of this study was delimited to Primary and Secondary Healthcare
Facilities in Ile-Ife and nursing mothers of children 0-1year attending
infant welfare clinics in selected healthcare facilities in Ile-Ife. The
study covers the four local governments in Ile-Ife, which are: Ife
Central Local Government, Ife East Local Government, Ife south local
government and Ife North local government respectfully.
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