Gaps in Compliance with Maternal and Child Health Interventions in Anambra State, Southeast Nigeria: A Qualitative Study

Abstract

Introduction: Despite the available interventions to curb child mortality, African countries south of the Sahara still account for half of the estimated 5.2 million deaths of under-5 children globally, with Nigeria ranking as the highest global contributor. Among interventions targeted at improving child health in Nigeria are childhood immunization, maternal antenatal care, and provision of insecticide treated bed-nets (ITN). However, compliance-related issues with these interventions abound. This study aimed at understanding the socio-cultural and contextual factors influencing compliance with these interventions in Anambra State, Nigeria, and deduces which of them has the best compliance.

Methods: A qualitative approach using in-depth interview (IDI) of senior health workers and focus group discussion (FGD) with purposively selected participants was employed. The FGD sessions were conducted separately for women and men.

Results: There were103 participants aged between 22 - 55 years, comprising 97 (women = 50; men = 47) for FGD, and 6 (all women) for IDI sessions. Our findings suggest adequacy of immunization service, adequate compliance with antenatal services, and good awareness about, and ownership of, ITNs. However, there are gaps in compliance with these interventions due to factors like religious beliefs, adverse events following immunization, and inadequate knowledge and equipment for setting up the ITNs.

Conclusions: Our findings show both availability and adequacy of the studied interventions in the area, but with gaps in the compliance level of the people. Failure to close the identified gaps therefore may impede the ability of the state to meet up with the SDG goals for health.