Geospatial Distribution, Accessibility and Utilization of Basic Emergency Obstetric and New-born Care in Jigawa State, Northwest Nigeria.

Zaharaddeen Shuaibu Babandi, Suleiman Usman, Bilkisu Gulma Abubakar, Ahmad Ayuba Umar, Auwal Garba Suleiman, Aqqad Tilde Aliyu, Maryam Fadila Isa, Tukur Dahiru
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Abstract

Background: High maternal mortality has remained a problem, especially in developing countries. Ensuring availability and utilization of Basic Emergency Obstetric and Newborn Care services (BEmONC) reduce maternal morbidity and mortality. The study aimed to determine the geospatial distribution, accessibility and utilization of BEmONC services in Jigawa State.

Methodology: A cross-sectional study was conducted using the WHO "30 by 7" cluster sampling technique and two-stage sampling to select 630 women and 15 Primary Health Care facilities (PHCFs) respectively. The Geo coordinates of the PHCFs and households of respondents were taken using the global positioning system (GPS) on Android devices. Data were analysed using IBM SPSS version 25 and Arc GIS version 10.6.

Results: A dispersed distribution was observed for the BEmONC facilities in two LGAs and majority of the respondents (71.9%) fall within 5 Km radius to a BEmONC facility. Only 27% of the respondents utilized BEmONC services for obstetric complications. Predictors of utilization of BEmONC were living within 5 Km to the nearest BEmONC (aOR=3.3; 95% CI=1.565 - 6.822), use of bicycle (aOR=1.930; 95% CI=1.012 - 3.679), cars (aOR=1.838; 95% CI=1.127 - 2.998), and tricycles (aOR=1.833; 95% CI=1.017 - 3.309) as means of transportation to PHCs.

Conclusions: A dispersed distribution and good physical accessibility to BEmONC facilities were found, however, utilization was poor. Distance and mode of transportation were predictors of utilization of BEmONC services. Jigawa State Government should intensify awareness campaigns to improve the utilization of BEmONC services and provide emergency transport schemes for women with obstetric complications.

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尼日利亚西北部吉加瓦州基本产科急诊和新生儿护理的地理空间分布、可及性和利用情况。
背景:产妇死亡率高仍然是一个问题,特别是在发展中国家。确保提供和利用基本产科急诊和新生儿护理服务,可降低孕产妇发病率和死亡率。该研究旨在确定吉加瓦州BEmONC服务的地理空间分布、可及性和利用情况。方法:采用世卫组织“30 × 7”整群抽样技术和两阶段抽样进行横断面研究,分别选择630名妇女和15个初级卫生保健机构。使用Android设备上的全球定位系统(GPS)获取初级保健中心和受访者家庭的地理坐标。数据分析采用IBM SPSS version 25和Arc GIS version 10.6。结果:BEmONC设施在两个地方自治团体中分布分散,大多数受访者(71.9%)位于BEmONC设施半径5公里范围内。只有27%的答复者利用BEmONC服务治疗产科并发症。预测者居住在距离最近的BEmONC 5 Km以内(aOR=3.3;95% CI=1.565 ~ 6.822),使用自行车(aOR=1.930;95% CI=1.012 - 3.679),汽车(aOR=1.838;95% CI=1.127 - 2.998)和三轮车(aOR=1.833;95% CI=1.017 - 3.309)作为前往初级保健中心的交通工具。结论:北京市卫生厅设施分布分散,可达性良好,但利用率较低。距离和运输方式是使用BEmONC服务的预测因子。吉加瓦州政府应加强宣传运动,以提高对产科中心服务的利用,并为患有产科并发症的妇女提供紧急运输计划。
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