Manpower capacity and reasons for staff shortage in primary health care maternity centres in Nigeria: a mixed-methods study
Manpower capacity and reasons for staff shortage in primary health care maternity centres in Nigeria: a mixed-methods study
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DOI：
10.1186/s12913-018-3819-x
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发表时间：
2019-01-07
影响因子：
2.8
通讯作者：
Modeste, R. R. Marie
中科院分区：
文献类型：
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作者：
Aluko, Joel O.;Anthea, Rhoda;Modeste, R. R. Marie
背景尼日利亚令人心碎的孕产妇和新生儿健康指标没有改善，尽管以前采取了干预措施，如“人人享有健康”和千年发展目标。如果现有模式保持不变，以前干预措施中与健康相关的目标/具体目标未能实现，新的可持续发展目标能否成功就成了疑问。因此，如果仅仅将卫生政策品牌化，而不改善卫生系统的组成部分，如人力资源和质量以及工作人员与病人的比例，将是徒劳的。这一问题的全球公共卫生关注提供了一个指标，用于描述人力资源的能力和工作人员短缺的原因，在初级卫生保健，提供孕产妇服务的妇女和他们的新的产妇在尼日利亚.MethodsThis是一个嵌入式混合方法的研究。它的定量链收集数据的帮助下，从127名卫生工作者在21个有目的地选择的初级卫生保健中心在五个地方政府地区的结构化问卷。采用描述性统计进行分析。研究的定性部分通过深入采访卫生部门的医务人员或其代表收集数据。磁带记录和转录的数据按主题编码，而报告则直接引用。混合的数据，从两个股进行了讨论section. ResultsTwenty九（22.8%）的卫生工作者年龄在51-58之间; 111（87.4%）已婚，而44（34.6%）的工作时间为21- 33年的服务。在卫生工作者中发现了不称职的证据。共有92人（72.4%）在分娩中对妇女进行了外阴切开术。同样，69.8%的人曾修复阴道创伤。九（7.1%）知道控制产后阴道出血的必要步骤，115（91.3%）未接受过救生计划和人工流产后护理培训。工作人员不称职和不适当的分娩做法表明，妇女在妇产中心得不到高质量的孕产妇和新生儿护理。
BackgroundThe 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.MethodsThis 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.ResultsTwenty-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 21-33years 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.ConclusionThe 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.