Multi-stakeholder perspectives on access, availability and utilization of emergency obstetric care services in Lagos, Nigeria: A mixed-methods study

Globally, Nigeria is the second most unsafe country to be pregnant, with Lagos, its economic nerve center having disproportionately higher maternal deaths than the national average. Emergency obstetric care (EmOC) is effective in reducing pregnancy related morbidities and mortalities. This mixed-methods study quantitatively assessed women's satisfaction with EmOC received and qualitatively engaged multiple key stakeholders to better understand issues around EmOC access, availability and utilization in Lagos. Qualitative interviews revealed that regarding access, while government opined that EmOC facilities have been strategically built across Lagos, women flagged issues with difficulty in access, compounded by perceived high EmOC cost. For availability, though health workers were judged competent, they appeared insufficient, overworked and felt poorly remunerated. Infrastructure was considered inadequate and paucity of blood and blood products remained commonplace. Although pregnant women positively rated the clinical aspects of care, as confirmed by the survey, satisfaction gaps remained in the areas of service delivery, care organization and responsiveness. These areas of discordance offer insight to opportunities for improvements, which would ensure that every woman can access and use quality EmOC that is sufficiently available

Awareness and Uptake of the Pap Smear among Market Women in Lagos; Nigeria

Our study evaluates the effect of an educational programme on awareness and uptake of the cervical cancer screening test (Pap smear) by women in a model market in Lagos Nigeria. This was a quasi-experimental study using a multistage sampling technique. A total of 350 women were divided into two groups. A baseline survey on awareness of the Pap test and screening practices was carried out using pre-tested; interviewer administered; structured questionnaires. Participants in the intervention group received sessions of community based health information on cervical cancer screening tests while participants in the control group received health information on hypertension. Subsequently; participants in both groups were reassessed to evaluate the effect of the educational programme on the Pap test and cervical screening uptake. Data were analysed with the Epi-info version 6.04. Awareness about the Pap test was low at baseline; only 6.9and 12.0of participants in the intervention and control groups; respectively; had heard of Pap smears. Furthermore; less than 10had correct information on the use of the Pap test. Post-intervention; there was a significant and proportional increase in the knowledge of the Pap test in the intervention group (p