What are pregnant women in a rural Niger Delta community's perceptions of conventional maternity service provision? An exploratory qualitative study.

At present there is under utilization of maternity service provision in Nigeria, with only a third of childbearing women electing to deliver in healthcare facilities. This is relevant since Nigeria's maternal mortality rate is second highest in the world and is estimated at 1,100 per 100,000 live births. To date, studies have sought cause and effect and have neglected the opinion of the people about what they perceive to be problematic and what they believe constitutes satisfactory maternity service provision. An exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's perceptions of conventional maternity service provision. Participants included 8 pregnant Niger Delta women from differing sub-groups within the homogeneous population. Semi-structured interviews were conducted to explore informants' views of what constitutes satisfactory maternity service provision, what comprises inadequate care, barriers that obstruct delivery of maternity care, and what promotes positive outcomes. Five major themes emerged from the data. These included: (1) Women's requirements for information; (1a) nutritional and dietary advice, (1b) how to recognise developing complications, (1c) appropriate fetal development, (1e) importance of attending clinics; (2) Staff services required: (2a) availability, (2b) well managed, and (2c) good quality; (3) Apparatus: (3a) equipment available, (3b) adequate infrastructure; (4) Affordability; (5) Place of traditional and spiritual methods. The interviewed childbearing Niger Delta women voiced several factors that they considered altered their satisfaction with maternity service provision. Finding out more about what causes satisfaction/dissatisfaction in childbearing women facilitates maternity care professionals to improve standards of care and allocate resources more effectively. Policy changes are driven by initiatives that reinforce strengths of current specification and recognise weaknesses. In addition, the WHO recommends that working towards improving health related culture is important.