RESUMO
BACKGROUND: Effective maternal and child healthcare delivery requires a proper and adequate funding of the health sector. OBJECTIVE: To determine the effect of government-community healthcare co-financing on maternal and child healthcare services' delivery. METHODS: A descriptive, cross-sectional study with an intervention component, conducted amongst 240 women from Igboukwu (intervention area), and Ekwuluobia (control area), of Anambra State of Nigeria. RESULTS: The biosocial characteristics of the respondents were essentially similar. Better utilization of health services occurred in the intervention area post-intervention. Quality of service from intervention clients' perspective showed significant improvement post-intervention. Distance less than five km, transportation cost less than N40, and maternal education above secondary level impacted positively on utilization of maternal and child health services. Acceptability of the scheme was better for the intervention facility evident from the higher number of respondents showing "willingness to join", and "willingness to pay". CONCLUSION: Health sector funding partnership, positively impacts on maternal and child health services. Government's total commitment, backed with legislation, and community mobilization, will sustain the scheme.
Assuntos
Serviços de Saúde da Criança/economia , Planejamento em Saúde Comunitária/organização & administração , Financiamento Governamental/economia , Seguro Saúde/economia , Serviços de Saúde Materna/estatística & dados numéricos , Adolescente , Adulto , Criança , Serviços de Saúde da Criança/estatística & dados numéricos , Estudos Transversais , Atenção à Saúde , Feminino , Grupos Focais , Humanos , Serviços de Saúde Materna/economia , Nigéria , Aceitação pelo Paciente de Cuidados de Saúde , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Fatores Socioeconômicos , Adulto JovemRESUMO
The incidence of twin birth among the Nigerian Igbos from this study is 1 in 36.2 or 27.6 per 1000. The commonest pair presentation was vertex/vertex and the incidence of pre-term delivery was 27.8%, six times higher than in single controls 4.5%. The commonest mode of delivery was spontaneous vertex. Breech delivery was most prevalent in the second twin while assisted delivery (forceps and ventouse) showed no difference between the twins themselves and between them and the controls. However, caesarean section rate was much higher for the twins, particularly the second twin compared to the singleton controls. Twin pregnancies and delivery being high risk, are best managed in specialist obstetrics and gynaecological centres.