Utilization of mental health services at the secondary health care level in a limited-resource setting

Context: Adequate prenatal and maternity services reduce maternal and perinatal morbidity and mortality in a population. In Nigeria, only a percentage of pregnant women attend prenatal clinics and deliver in the hospital. Objective: To evaluate the level of utilization and factors militating against uptake of maternal health services at the secondary health care facility. Methods: The researchers using semi-structured questionnaire in a cross-sectional study interviewed consenting expectant mothers from 3 randomly selected communities in Ebonyi State. Medical officers at the secondary level Healthcare facilities were also interviewed to assess volume of referrals. The study lasted 3 months. Main Outcome Measures: Utilization of maternal health services by the respondents. Results: About 90% of the 150 respondents were aware of the prenatal/maternity services in the General hospitals. The mean age of the respondents was 26.3+1 year. Women of the lower parities (<4) were more likely to utilize 2 maternity services at the facilities than their grandmultiparous counterparts (X = 15.51; p value < 0.05). Women of 2 higher educational status also patronized the General hospitals more often. ( X =30.4; P < 0.05). Only 17.2% of the 172 respondents who had previously utilized such facilities were willing to continue further patronage. The nonavailability of doctors, poor quality services, lack of drugs and equipment, transport difficulties and negative attitudes of health personnel, were reasons for their disinterest. Conclusion: Community mobilization, improvement in staffing, equipment, drug supplies and infrastructure, will optimize uptake of prenatal and maternity services at the secondary health care level.