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PREVENTION OF MATERNAL MORTALITY: A COMMUNITY ACTION RESEARCH IN BAKASSI LOCAL GOVERNMENT AREA,CROSS RIVER STATE, NIGERIA

Esienumoh, Ekpoanwan

[Thesis]. Manchester, UK: The University of Manchester; 2011.

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Abstract

ABSTRACTTHE UNIVERSITY OF MANCHESTERABSTRACT OF THE THESIS submitted by Ekpoanwan Esienumoh Esienumoh for the degree of Doctor of Philosophy titled Prevention of maternal mortality: A community action research in Bakassi Local Government Area, Cross River State, Nigeria.January, 2011.Maternal mortality in Nigeria is one of the highest in the world. The rate is higher in the rural communities than in the urban. Given the complexity of causes of maternal mortality, it appears that the community is an important resource that is frequently overlooked. The contribution of which could be explored through collaboration with professional healthcare providers, to bring about reduction in maternal mortality.This study, proposed to empower members of the community to take action to prevent maternal mortality. Action research design was utilised, comprising cycles of fact-finding, planning/action, and evaluation with the aim of working towards a change in the status quo.In collaboration with the action research group, data were generated through 29 interviews, 8 focus group discussions and observation of 7 persons. Women of childbearing age were interviewed to gain understanding of their knowledge, attitude and practice towards maternal mortality. Focus group discussions were carried out with a cross section of the community. Observations were undertaken of skilled and traditional birth attendants (TBAs) in their places of practice. Altogether, there were 86 general participants and 12 action research group members in the study.Thematic data analysis and critical reflection were undertaken with emphasis on data which promote learning and change. The study revealed childbirth fallacies as evidenced in the causes of maternal deaths being attributed to superstitious beliefs. Other findings included religious beliefs/practices, birth practices, negative attitudes, lack of money, lack of transportation and health facilities issues as contributory factors. These findings were critically reflected upon by the action research group and actions based on the findings, aimed at empowering the people to take action to prevent maternal deaths were undertaken. The actions included community education, TBA training and development of a common forum between skilled birth attendants and TBAs.Participatory evaluation was undertaken from the perspectives of the participants to identify what made sense to them from the actions. Findings included some degree of empowerment and emancipation of the people evidenced in the acquisition of new knowledge which led to the repudiation of certain superstitious beliefs. Other findings include resumed utilisation of the service of skilled birth attendants at the local health facility by the women. The findings of this study have demonstrated implications for practice, policy and research to prevent maternal mortality in Bakassi LGA, Nigeria.Conclusion drawn is that, the community is an important resource which if mobilised through the process of action research, would be empowered to take action to prevent maternal mortality. The process will also foster the collaboration between skilled birth attendants and traditional birth attendants to improve maternal health care in the rural community.