Midwifery and Midwives Service Scheme: A Panacea for Improvement of Some Maternal and Neonatal Indices in Nigeria—A Brief Review

Abstract

Introduction: Midwifery is the art of\rcaring for women during childbearing. It is practiced throughout the world\raccording to the norms, traditions and cultural practices found in each\rcountry. Maternal mortality in Nigeria is high but there are wide variations\rbetween the geopolitical zones of the country. Government has established the\rmidwives service scheme (MSS) as part of efforts towards reversing the country’s\runacceptably high maternal mortality trends. To improve these indices, the MSS\rin Nigeria engaged newly graduated unemployed and retired midwives to work\rtemporarily in rural areas. The midwives are posted for twelve months to\rselected primary care facilities linked through a cluster model in which four\rsuch facilities with the capacity to provide basic essential obstetric care are\rclustered around a secondary care facility with the capacity to provide\rcomprehensive emergency obstetric care. This brief review is an attempt at\rexploring the impact of the midwives service scheme on maternal and neonatal\rindices in Nigeria. Main content: The outcome of the MSS four\ryears has been an improvement though unevenly and marginally, in these indices\rin the various geopolitical zones of Nigeria. Improvements have been noticed in\rmaternal indices such as antenatal care attendance, women receiving two doses\rof tetanus toxoid and number of deliveries by skilled personnel. Also reduction\rin maternal and neonatal mortality has been observed over the years following\rintroduction of the scheme. Major challenges however, include lack of essential\rdrugs, poor accommodation facilities for MSS staff, irregular payment of their\rremuneration and lack of water/power supply to some designated facilities for\rthe scheme. Recommendations\rand conclusions: It is therefore recommended that 24 hours availability of\ressential drugs at primary healthcare centers be maintained. This should happen\rin conjunction with regular payment of full entitlements and benefits and\rprovision of secured, habitable and good accommodation for MSS staff. Finally,\raggressive community mobilization should continue in order to engender\rcommunity involvement and participation for sustainable program development.