Résumé
Background: To upturn the poor maternal, children
and neonatal health indicators in a South-west
Nigerian state, the Abiye Scheme was inaugurated
in 2009. This study assessed the perception of
healthcare workers and end-users in Ondo State
about the implementation of the four strategies
proposed to actualise this scheme.
Methods: This qualitative study employed the use
of 15 key informant interviews (KIIs) conducted
among 15 healthcare workers and eight focus group
discussions (FGDs) conducted among 72 pregnant
and nursing mothers to generate essential data. The
Abiye scheme strategies assessed were the
establishment of a health insurance scheme; utilization
of health rangers (HR); upgrade and renovation of
peripheral health facilities; and establishment of
mother and child hospitals. All interviews were audio
recorded, transcribed verbatim, coded, and analysed
with Nvivo 10 software using framework analysis
via deductive methods.
Results: The study respondents perceived the Abiye
scheme as a well-conceptualized program with good
intentions. Only the establishment of the mother and
child hospitals strategy of the Abiye scheme was
perceived to be properly implemented by our study
respondents. According to the respondents, the health
insurance scheme was nearly non-existent.
Conclusion: Abiye scheme is undisputedly a well
conceptualized program that has impacted positively
its users. Nonetheless, the laid down strategies have
not been fully implemented. To achieve maximal
impact, the health rangers must be enabled to perform
their duties; the health insurance component must be
strengthened and properly implemented; and the
peripheral health facilities should be quickly and
actively co-opted into the scheme.
Références
World Bank. Millenium Development Goals
[Internet]. 2013 [cited 2015 Mar 24]. Available
from: http://www.worldbank.org/mdgs/
maternal_health.html Accessed March 24th 2015
United Nations. The Sustainable Development
Goals Report 2018. Sustainable Development
Goals. Washington, DC; 2017. p. 1–40.
WHO. Cildren: Reducing Mortality. 2019.
NIPORT. An Ethnographic Research on Newborn
Care Practices in Rural Bangladesh. Azimpur
Dhaka, Bangladesh; 2002.
WHO. World Health Statistics, 2015 [Internet].
Washington DC; 2015. Available from: http://
apps.who.int/iris/bitstream/10665/170250/1/
_eng.pdf
Becher H, Muller O, Jahn A, et al. Risk factor of
infant mortality in sub-saharan Africa. New York;
Knoema. Nigeria - Under-five mortality rate.
World Data Atlas. 2019.
Morakinyo OM and Fagbamigbe AF. Neonatal ,
infant and under-five mortalities in Nigeria/ : An
examination of trends and drivers ( 2003-2013 ).
PLoS One [Internet]. 2017;12(8):e0182990.
Available from: http://dx.doi.org/10.1371/
journal.pone.0182990%0A
UNICEF. Maternal Mortality. UNICEF DATA.
National Population Commission(NPC)[Nigeria]
and ICF. 2019. Nigeria Demographic and Health
Survey 2018. Abuja, Nigeria, And Rockville,
Maryland, USA: NPC and ICF; 2019.
Ashir GM, Doctor H V and Afenyadu GY.
Performance Based Financing and Uptake of
Maternal and Child Health Services in Yobe Sate,
AF Fagbamigbe, TA Obembe and BE Owumi
Northern Nigeria. Glob J Heal Sci. 2013;5(3):34–
Doctor H V., Bairagi R, Findley SE and
Helleringer S. Northern Nigeria Maternal,
Newborn and Child Health Programme/ :
Selected Analyses from Population-Based
Baseline Survey. Open Demogr J. 2011;4:11–21.
Gyimah SO. Polygynous marital structure and
child survivorship in sub-Saharan Africa: Some
empirical evidence from Ghana. Soc Sci Med
[Internet]. 2008;68(2):334–42. Available from:
h t t p : / / d x . d o i . o r g / 1 0 . 1 0 1 6 /
j.socscimed.2008.09.067
Fatusi AO and Ijadunola KT. National Study on
Essential Obstetric Care Facilities in Nigeria.
Abuja, Nigeria; 2003.
FMoH. National HIV Sero-prevalence Sentinel
Survey among Pregnant Women attaending
Antenatal clinics in Nigeria. Federal Ministry of
Health, Abuja, Nigeria; 2010.
Macdonald T, Jackson S, Charles M, et al. The
fourth delay and community-driven solutions to
reduce maternal mortality in rural Haiti/ : a
community-based action research study. BMC
Pregnancy Childbirth. BMC Pregnancy and
Childbirth; 2018;1–12.
ODSG-MoH. Abiye - Safe Motherhood
[Internet]. The Abiye programme. 2013.
Available from: http://www.mdgs.gov.ng/
index.php/mdg-goals/goal-4
Mimiko O. Experiences with Universal Health
Coverage of Maternal Health Care in Ondo
State, Nigeria, 2009-2017. Afr J Reprod Health.
;21(September):9–26.
Bradley EH, Curry LA et al. Devers KJ.
Qualitative Data Analysis for Health Services
Research: Developing Taxonomy, Themes, and
Theory. Health Serv Res. 2007;42(4):1758–72.
Ezeoke OP, Onwujekwe OE and Uzochukwu BS.
Towards Universal Coverage: Examining Costs of
Illness, Payment, and Coping Strategies to Different
Population Groups in Southeast Nigeria. Am J Trop
Med Hyg. 2012;86(1):52–57.
Babalola S and Fatusi AO. Determinants of use
of maternal health services in Nigeria: looking
beyond individual and household factors. BMC
Pregnancy Childbirth. 2009;9(43):1–15.
Okoli U, Abdullahi MJ, Pate M A, et al.Abubakar
IS, Aniebue N, West C. Prenatal care and basic
emergency obstetric care services provided at
primary healthcare facilities in rural Nigeria. Int
J Gynaecol Obstet. International Federation of
Gynecology and Obstetrics; 2012;117(1):61–5.
Fapohunda BM and Orobaton NG. When Women
Deliver with No One Present in Nigeria: Who,
What, Where and So What? PLoS One.
;8(7).
NPHCDA. Nigeria Midwives Service Scheme.
Health Care. 2011.
Cooke JG, Tahir F. Maternal health in Nigeria:
With leadership, progress is possible. Cent Strateg
Int Stud. 2013;(January):1–22.
Oyeyemi SO and Wynn R. Giving cell phones to
pregnant women and improving services may
increase primary health facility utilization: A casecontrol study of a Nigerian project. Reprod
Health. 2014;11(1):1–8.
Isola OO. The Use of Mobile Telephone in
reducing pre-natal maternal mortality: Case Study
of Abiye (Safe Motherhood) Project in Ondo
State, Southwest Nigeria. InParis: A Paper
Presented at the International Conference on
Habitele in University Sciences Po 2013.; 1369.
Van Malderen C, Amouzou A, Barros AJD, et
al. Socioeconomic factors contributing to underfive mortality in sub-Saharan Africa: a
decomposition analysis. BMC Public Health.
Dec;19(1):760.
Scheppers E, Van Dongen E, Dekker J, Geertzen
J and Dekker J. Potential barriers to the use of
health services among ethnic minorities: a review.
Fam Pract [Internet]. 2006 Jun [cited 2014 Jul
;23(3):325–48. Available from: http://
www.ncbi.nlm.nih.gov/pubmed/16476700
Fagbamigbe AF, Olaseinde O and Setlhare V.
Sub-national analysis and determinants of
numbers of antenatal care contacts in Nigeria/ :
assessing the compliance with the WHO
recommended standard guidelines. BMC
Pregnancy Childbirth [Internet]. BMC
Pregnancy and Childbirth; 2021;21(402):1–19.
Available from: https://doi.org/10.1186/s12884-
-03837-y
Fagbamigbe AF and Nnanatu CC. Modelling the
Spatial Distribution and the Factors Associated
with Under-Five Mortality in Nigeria. Spat
Demogr [Internet]. 2021 Mar 29 [cited 2021 Mar