The contribution of privately owned hospitals in the provision of essential obstetric care in Nigeria.

OBJECTIVE: To highlight the private sector contribution in the provision of essential obstetric care in Abia State, Southeastern Nigeria.
METHOD: Following two workshops a structured questionnaire was used to seek information on the type of facility, ownership, type of services, number of staff, instruments and medical consumables, deliveries and data on clients attended to in the previous twelve months. On the basis of the response the facilities were classified into not essential obstetric care, basic essential obstetric care and comprehensive essential obstetric care.
RESULTS: Of 638 facilities visited only 378 offered antenatal and postnatal services. The 13 government hospitals and 173 primary health centers conducted 5601 deliveries. The 146 private hospitals/clinics and 46 maternity homes conducted 21,128 deliveries. Only 121 offered essential obstetric services: 42 basic with 2488 deliveries and 79 comprehensive with 14,489 deliveries. Of the basic essential obstetric facilities that were private, 84.6% were concentrated in the 6 urban local government areas (LGA) leaving 15.4% in the 11 rural LGA. Similarly 85.6% of the comprehensive essential obstetric facilities that were private are concentrated in the 6 urban LGA leaving 14.4% scattered in the 11 rural LGA
CONCLUSION: The private sector, with its greater essential obstetric facilities, is concentrated mainly in the 6 urban LGA. This resulted in 14,970 deliveries as against 2007 deliveries in the government facilities. Although there is an apparent neglect of the other 11 LGA, the deliveries in the private facilities constituted over 79% within the study period. This greater contribution should be noted and considered when planning maternal and infant mortality and morbidity reforms in Nigeria.