Outcome of interventions to improve the quality of intrapartum care in Nigeria's referral hospitals: a quasi-experimental research design.

Background: Evidence indicates that Nigeria's high maternal mortality rate is attributable primarily to events that occur during the intrapartum period. This study determines the effectiveness of multifaceted interventions in improving the quality of intrapartum care in Nigeria's referral hospitals.

Methods: Data collected through an exit interview with 752 women who received intrapartum care in intervention and control hospitals were analyzed.

Outcomes of a multifaceted intervention to prevent eclampsia and eclampsia-related deaths in Nigerian referral facilities.

Background: Eclampsia causes maternal mortality in Nigeria. This study presents the effectiveness of multifaceted interventions that addressed institutional barriers in reducing the incidence and case fatality rates associated with eclampsia.

Methods: The design was quasi-experimental and the activities implemented at intervention hospitals included a new strategic plan, retraining health providers on eclampsia management protocols, clinical reviews of delivery care and educating pregnant women and their partners.

The Case for Early and Universal Screening for Gestational Diabetes Mellitus: Findings from 9314 Pregnant Women in a Major City in Nigeria.

Introduction: Risk-based screening has been replaced by universal screening as the recommended course of care for gestational diabetes mellitus (GDM). As of 2016, no state in Nigeria had implemented a policy of universal screening for GDM. This research aimed to assess findings from a universal screening programme and its implication for scaling up universal and early screening for GDM.

Effectiveness of Glycated Haemoglobin in the Diagnosis of Gestational Diabetes Mellitus among Pregnant Women in Port Harcourt, Nigeria.

Background: Gestational Diabetes Mellitus (GDM) is a common metabolic complication in pregnancy with a broad range of adverse foetal and maternal outcomes if not properly managed. Due to the difficult nature of the Oral glucose tolerance test (OGTT), the utilization of the Glycatedhaemoglobin (HbA1c) test as a simpler and acceptable alternative has been suggested. The aims were to determine the GDM prevalence, the diagnostic accuracy, the optimal cut-off point and the validity of the HbA1c in diagnosing GDM using OGTT as the gold standard in the University of Port Harcourt Teaching Hospital (UPTH).

The increasing use of the WHO Safe Childbirth Checklist: lessons learned at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon.

Background: Safe childbirth remains a daunting challenge, particularly in low-middle income countries, where most pregnancy-related deaths occur. Cameroon's maternal mortality rate, estimated at 529 per 100,000 live births in 2017, is significantly high. The WHO Safe Childbirth Checklist (SCC) was designed to improve the quality of care provided to pregnant women during childbirth.

Outcomes of a multifaceted intervention to improve maternal satisfaction with care in secondary hospitals in Nigeria.

: Data in Nigeria suggests a high level of dissatisfaction among women attending maternity care in health facilities due to long wait times, disrespectful care, and poor attention by healthcare personnel. : To examine the effectiveness of a multifaceted intervention in improving self-reported indicators of maternal healthcare satisfaction by women who use referral facilities in two regions of Nigeria. : The design was quasi-experimental and consisted of two intervention facilities and two control facilities.

Outcome of multifaceted interventions for improving the quality of antenatal care in Nigerian referral hospitals.

Background: The study was designed as quasi-experimental research to investigate the effectiveness of multifaceted interventions for improving the quality of antenatal care in referral hospitals in Nigeria. Two referral hospitals (the Central Hospital in Benin City, South-South Nigeria, and the General Hospital in Minna) served as intervention sites, while two hospitals in comparable locations, (the Central Hospital Warri and the Suleja Hospital Abuja) were the control hospitals.

Methods: Intervention activities consisted of the introduction of a strategic plan with the shared vision of reducing maternal mortality by 50% in 1 year in the hospitals; staff training and re-training; the establishment of an automated appointment system; composite health education involving couples and providers; advocacy with policymakers; and the implementation of maternal death reviews and surveillance.

Review of Episiotomy and the Effect of its Risk Factors on Postepisiotomy Complications at the University of Port Harcourt Teaching Hospital.

Aim: This study aimed to determine the prevalence of episiotomy and postepisiotomy complications and to assess the relationship between the risk factors and postepisiotomy complications in the University of Port Harcourt Teaching Hospital.

Methodology: This was a descriptive longitudinal study, in which 403 consecutive women who had episiotomy in the labor ward were recruited for the study. They were followed up and reviewed at the postnatal clinic on the 1 and 6 weeks postdelivery.

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study.

Background: In 2015, Nigeria's estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths.

Assessing the knowledge and skills on emergency obstetric care among health providers: Implications for health systems strengthening in Nigeria.

Objective: To assess the existing knowledge and skills relating to Emergency Obstetrics Care (EMOC) among health providers in eight referral maternity hospitals in Nigeria.

Study Design: A cross-sectional study of skilled health providers (doctors, nurses and midwives) working in the hospitals during the period.

Setting: Six general hospitals (4 in the south and 2 in the north), and two teaching hospitals (both in the Northern part) of the country.

Where do delays occur when women receive antenatal care? A client flow multi-site study in four health facilities in Nigeria.

Objectives: The objective of the study was to identify where delays occur when women present for antenatal care in four Nigerian referral hospitals, and to make recommendations on ways to reduce delays in the course of provision of antenatal care in the hospitals.

Design: Prospective observational study.

Setting: Four Nigerian (1 tertiary and 3 secondary) Hospitals.

Association of the client-provider ratio with the risk of maternal mortality in referral hospitals: a multi-site study in Nigeria.

Background: The paucity of human resources for health buoyed by excessive workloads has been identified as being responsible for poor quality obstetric care, which leads to high maternal mortality in Nigeria. While there is anecdotal and qualitative research to support this observation, limited quantitative studies have been conducted to test the association between the number and density of human resources and risk of maternal mortality. This study aims to investigate the association between client-provider ratios for antenatal and delivery care and the risk of maternal mortality in 8 referral hospitals in Nigeria.

Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: a multicenter study.

Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria.

Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria.

Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria.

Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women's Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations.

Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria.

Background: Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care.

Qualitative assessment of women's satisfaction with maternal health care in referral hospitals in Nigeria.

Background: Available evidence suggests that the low use of antenatal, delivery, and post-natal services by Nigerian women may be due to their perceptions of low quality of care in health facilities. This study investigated the perceptions of women regarding their satisfaction with the maternity services offered in secondary and tertiary hospitals in Nigeria.

Methods: Five focus group discussions (FGDs) were held with women in eight secondary and tertiary hospitals in four of the six geo-political zones of the country.

Management of aplastic anaemia in pregnancy in a resource poor centre.

Aplastic anaemia occurring in pregnancy is a rare event with life threatening challenges for both mother and child. We present a successful fetomaternal outcome despite the challenges in the management of this rare condition in a tertiary but resource poor centre. This is case of a 37 year old Nigerian woman G6P0managed with repeated blood transfusions from 28 weeks of gestation for bone marrow biopsy confirmed aplastic anaemia following presentation with weakness and gingival bleeds.

Engendering the Attainment of the SDG-3 in Africa: Overcoming the Socio Cultural Factors Contributing to Maternal Mortality.

At the conclusion of the Millennium Development Goals (MDGs), the Sustainable Development Goals (SDGs) provide an opportunity to ensure healthy lives, promote the social well-being of women and end preventable maternal death. However, inequities in health and avoidable health inequalities occasioned by adverse social, cultural and economic influences and policies are major determinants as to whether a woman can access evidence-based clinical and preventative interventions for reducing maternal mortality. This review discusses sociocultural influences that contribute to the high rate of maternal mortality in Nigeria, a country categorised as having made -no progress‖ towards achieving MDG 5.

Community based interventions for the reduction of maternal mortality - the role of professional health associations, non-governmental organisations and community-based organisations in delta state, Nigeria.

Aims And Objectives: This study was conducted to examine the contributions of professional health associations, non-governmental organisations, government ministries, and community-based organisations in implementing community-based interventions for the reduction of maternal mortality in Delta State Nigeria. It also seeks to demonstrate the challenge of coordinating activities of several stakeholders and quantifying the impact on reduction of maternal mortality.

Materials And Methods: Various publications, reports, public presentations and policy documents on activities of professional health associations, non- governmental organisations, government ministries, and community-based organisations in Delta State of Nigeria were collected and analysed by the authors.

Submucous uterine fibroid mimicking ruptured ectopic gestation: a case report.

Ectopic pregnancy is the greatest mimic in gynaecology. Ruptured ectopic gestation usually presents with syncope and severe anaemia. We report the clinical dilemma exposed by the management of a 22-year-old student who presented with syncope and severe anaemia due to a small solitary submucous uterine fibroid.

Assessment of sublingual misoprostol as first-line treatment for primary post-partum hemorrhage: results of a multicenter trial.

Aim: The study investigated the effectiveness of sublingual misoprostol when used as primary treatment of primary post-partum hemorrhage (PPH) in a low-income country.

Methods: Maternity care providers in three Nigerian hospitals administrated 800 μm sublingual misoprostol to women experiencing PPH. The outcome variables were estimated blood loss and the need for additional uterotonic drugs after initial treatment with misoprostol.