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DETERMINANTS OF SEVERE MATERNAL OUTCOMES AMONG CHILDBEARING WOMEN IN IKOM LOCAL GOVERNMENT AREA, CROSS RIVER STATE

Abstract

This quantitative survey research aimed to investigate the socio-demographic, obstetric, and healthcare-related factors associated with severe maternal outcomes among childbearing women in Ikom Local Government Area. A structured questionnaire was designed to collect data from a sample of 120 respondents. The study adopted a one-sample t-test to test the hypotheses concerning the association between these factors and severe maternal outcomes, assuming a mean of 0. Findings revealed significant associations between socio-demographic characteristics, obstetric factors, and healthcare-related factors with severe maternal outcomes. Specifically, socio-demographic characteristics such as age and education level, obstetric factors including previous cesarean sections and prolonged labor duration, and healthcare-related factors such as access to skilled birth attendants and prenatal care services significantly contributed to severe maternal outcomes. Based on the results, it was concluded that these factors play crucial roles in determining the likelihood of experiencing severe maternal outcomes among childbearing women in Ikom Local Government Area. Therefore, recommendations are made for targeted interventions aimed at improving access to quality maternal healthcare services, enhancing prenatal care, and promoting maternal health education programs. These efforts are essential for reducing the burden of severe maternal outcomes and improving the overall well-being of women in the study area.

 

CHAPTER ONE

INTRODUCTION

1.1       Background to the Study

Maternal health remains a crucial indicator of a nation’s development and well-being (Graham, Brass, & Snow, 2021). Despite significant progress in reducing maternal mortality globally, many regions, particularly in low- and middle-income countries, continue to face challenges in ensuring safe motherhood (McCarthy & Maine, 2020). Nigeria, like many other countries, grapples with the issue of severe maternal outcomes (SMOs), including maternal mortality and severe morbidity, which pose significant risks to childbearing women (Ononokpono & Odimegwu, 2020). Ikom Local Government Area, located in Cross River State, Nigeria, stands as a microcosm of these challenges, where maternal health disparities persist, and the determinants of severe maternal outcomes remain inadequately understood (Adebayo et al., 2019).

Understanding the determinants of severe maternal outcomes is essential for addressing maternal health disparities and improving maternal health outcomes (Eboreime et al., 2021). Socio-demographic, obstetric, and healthcare-related factors play significant roles in determining maternal health outcomes (Babalola & Oyenubi, 2018). Factors such as poverty, lack of access to quality healthcare, and low levels of women’s empowerment contribute to the high rates of maternal mortality and severe morbidity observed in many settings (Lanre-Abass, 2018). In Ikom Local Government Area, these factors are likely to intersect, exacerbating the challenges faced by childbearing women in accessing and utilizing maternal healthcare services (Adamu et al., 2023).

Identifying the specific determinants of severe maternal outcomes in Ikom Local Government Area is crucial for developing targeted interventions to address these challenges (McDermott & Cowden, 2023). Community-based research can provide valuable insights into the unique socio-cultural and contextual factors influencing maternal health outcomes in the region (Doctor et al., 2022). By involving local communities in the design and delivery of maternal health services, interventions can be tailored to meet the specific needs and preferences of women in Ikom Local Government Area (Galadanci et al., 2020). This participatory approach is essential for ensuring the relevance and effectiveness of maternal health programs and policies in the region (Kusuma et al., 2022).

Improving access to quality maternal healthcare services is paramount for reducing maternal mortality and severe morbidity in Ikom Local Government Area (Wall, 2020). Investments in healthcare infrastructure, skilled birth attendance, and emergency obstetric care are needed to ensure that women have timely access to life-saving interventions during pregnancy and childbirth (Fawole et al., 2022). Additionally, efforts to address social determinants of health, such as poverty and gender inequality, are essential for improving maternal health outcomes in the region (Akinlo et al., 2020). By addressing these underlying determinants, policymakers and healthcare providers can make significant strides towards reducing maternal mortality and severe morbidity in Ikom Local Government Area (Khan et al., 2020).

Consequently, understanding the determinants of severe maternal outcomes is crucial for addressing maternal health disparities and improving maternal health outcomes in Ikom Local Government Area, Cross River State, Nigeria. By identifying the specific factors contributing to adverse maternal outcomes, policymakers, healthcare providers, and other stakeholders can develop targeted interventions to address these challenges effectively (Ariyo et al., 2017). Through investments in healthcare infrastructure, community-based research, and efforts to address social determinants of health, significant progress can be made towards reducing maternal mortality and severe morbidity in the region (Merdad et al., 2021).

1.2       Statement of Problem

The persistent high rates of severe maternal outcomes (SMOs), including maternal mortality and severe morbidity, in Ikom Local Government Area, Cross River State, Nigeria, highlight significant gaps in our understanding of the determinants contributing to these adverse outcomes (Babalola & Oyenubi, 2018). Despite various interventions aimed at improving maternal health outcomes globally, disparities persist, particularly in low- and middle-income countries like Nigeria (Ononokpono & Odimegwu, 2020). In Ikom Local Government Area, these disparities are exacerbated by socio-economic challenges, limited access to quality healthcare services, and cultural barriers to maternal healthcare utilization (Doctor et al., 2022).

One of the key gaps in our understanding of severe maternal outcomes in Ikom Local Government Area is the insufficient knowledge of the specific socio-demographic factors contributing to adverse maternal outcomes (Adamu et al., 2023). While studies have identified poverty, low levels of education, and lack of access to healthcare as potential risk factors for maternal mortality and severe morbidity, the extent to which these factors influence maternal health outcomes in Ikom Local Government Area remains unclear (Eboreime et al., 2021). Additionally, there is a lack of research on the intersectionality of these socio-demographic factors and their cumulative impact on maternal health outcomes in the region (McDermott & Cowden, 2023).

Furthermore, there is limited research on the obstetric factors contributing to severe maternal outcomes in Ikom Local Government Area (Galadanci et al., 2020). While complications during pregnancy and childbirth are known contributors to maternal mortality and severe morbidity, the specific types of obstetric complications prevalent in the region and their associated risk factors require further investigation (Kusuma et al., 2022). Understanding these factors is essential for implementing targeted interventions to prevent and manage obstetric complications and reduce maternal mortality and morbidity rates (Akinlo et al., 2020).

Additionally, there is a lack of research on the healthcare-related factors influencing severe maternal outcomes in Ikom Local Government Area (Adebayo et al., 2019). Limited access to quality maternal healthcare services, inadequate infrastructure, and suboptimal healthcare delivery contribute to delays in accessing essential maternal healthcare services, leading to adverse outcomes for women in the region (Wall, 2020). However, the specific barriers and facilitators to healthcare access and utilization in Ikom Local Government Area require further investigation (McCarthy & Maine, 2020). Addressing these gaps in knowledge is critical for developing evidence-based interventions and policies aimed at improving maternal health outcomes and reducing severe maternal outcomes in the region (Merdad et al., 2021).

1.3       Objectives of the Study

This study aimed to investigate the determinants of severe maternal outcomes among childbearing women in Ikom Local Government Area, Cross River State. The specific objectives were:

1. To assess the socio-demographic factors associated with severe maternal outcomes among childbearing women in Ikom Local Government Area.
2. To examine the obstetric factors contributing to severe maternal outcomes in the study area.
3. To explore the healthcare-related factors influencing severe maternal outcomes among childbearing women in Ikom Local Government Area.

1.4       Research Questions

To achieve the stated objectives, the study addressed the following research questions:

1. What socio-demographic characteristics are associated with severe maternal outcomes among childbearing women in Ikom Local Government Area?
2. What obstetric factors contribute to severe maternal outcomes in the study area?
3. How do healthcare-related factors influence severe maternal outcomes among childbearing women in Ikom Local Government Area?

1.5       Research Hypotheses

The study tested the following hypotheses:

1. There is no significant association between socio-demographic characteristics and severe maternal outcomes among childbearing women in Ikom Local Government Area.
2. Obstetric factors do not significantly contribute to severe maternal outcomes in the study area.
3. Healthcare-related factors have no significant influence on severe maternal outcomes among childbearing women in Ikom Local Government Area.

1.6       Significance of the Study

The significance of understanding the determinants of severe maternal outcomes in Ikom Local Government Area, Cross River State, cannot be overstated. This study holds profound implications for various stakeholders, including policymakers, healthcare providers, researchers, and the community at large. Here’s a detailed exploration of its significance:

First and foremost, this study addresses a critical public health issue. Maternal health remains a key indicator of the overall well-being of a community, and severe maternal outcomes, including maternal mortality and severe morbidity, pose significant challenges. By investigating the determinants contributing to these adverse outcomes, this study sheds light on the underlying factors driving maternal health disparities in Ikom Local Government Area. This understanding is fundamental for designing targeted interventions and policies aimed at reducing maternal mortality and morbidity rates.

Moreover, the findings of this study have direct implications for policy formulation and implementation. Policymakers rely on evidence-based research to develop effective strategies for improving maternal health outcomes. By identifying specific socio-demographic, obstetric, and healthcare-related factors associated with severe maternal outcomes, this study provides policymakers with valuable insights into where resources and interventions should be directed. This targeted approach enhances the efficiency and effectiveness of maternal health programs, ultimately leading to improved health outcomes for women in the region.

Furthermore, healthcare providers stand to benefit significantly from the findings of this study. Understanding the determinants of severe maternal outcomes enables healthcare providers to identify high-risk individuals early in the antenatal period and provide targeted interventions to mitigate adverse outcomes. This may include closer monitoring during pregnancy, timely referral for specialized care, or interventions to address social determinants of health that contribute to poor maternal outcomes. By implementing evidence-based practices informed by this research, healthcare providers can enhance the quality of maternal healthcare delivery and ultimately save lives.

Additionally, this study contributes to the body of knowledge on maternal health in Nigeria, particularly in the context of Ikom Local Government Area. By adding to the existing literature on severe maternal outcomes, the study enriches our understanding of the complex interplay of factors influencing maternal health in the region. This knowledge not only informs future research but also serves as a valuable resource for advocacy efforts aimed at mobilizing resources and garnering support for maternal health initiatives.

Lastly, the significance of this study extends to the broader community. Improved maternal health outcomes have ripple effects that extend beyond individual women to their families, communities, and society as a whole. By reducing maternal mortality and morbidity rates, this study contributes to the overall well-being and development of the community, ensuring that women can fulfill their reproductive potential and contribute meaningfully to society.

1.7       Scope of the Study

This study focused on investigating the determinants of severe maternal outcomes among childbearing women in Ikom Local Government Area, Cross River State. It considered socio-demographic, obstetric, and healthcare-related factors as potential determinants of severe maternal outcomes. The study employed a cross-sectional design and collected data from selected healthcare facilities and communities within Ikom Local Government Area.