The midwives service scheme in Nigeria

Area of Science:

• Public Health
• Healthcare Delivery
• Maternal and Child Health

Background:

• Maternal, newborn, and child health (MNCH) indicators in Nigeria exhibit significant disparities across geopolitical zones and between urban and rural settings.
• A primary driver of these disparities is the inconsistent availability of skilled birth attendants.

Purpose of the Study:

• To evaluate the impact of the Midwives Service Scheme (MSS) on MNCH indices in Nigeria.
• To identify challenges and successes of the MSS in improving access to skilled birth attendance in rural areas.

Main Methods:

• The Midwives Service Scheme (MSS) deployed newly graduated, unemployed, and retired midwives to rural primary care facilities for one-year temporary assignments.
• Facilities were organized in a cluster model, with four primary care facilities linked to a secondary care facility offering comprehensive emergency obstetric care.

Main Results:

• The MSS demonstrated uneven improvements in MNCH indices across Nigeria's six geopolitical zones after one year.
• Key challenges identified include difficulties in midwife retention, training, and varying governmental commitment.
• Despite increased availability of skilled birth attendants at MSS facilities, home deliveries remain prevalent in certain areas.

Conclusions:

• The MSS has shown potential in improving MNCH outcomes but faces significant implementation hurdles.
• Sustained improvements require addressing midwife retention, ensuring consistent training, and strengthening governmental support at all levels.
• Community engagement and addressing socio-cultural factors influencing delivery location choices are crucial for maximizing the scheme's impact.