Demand and supply analysis for maternal and child health services at the primary healthcare level in Nigeria

Abstract

Background The low usage (demand) of maternity and child health (MCH) services is a key contributor to the high maternal death rate in most regions of Nigeria. A special health programme called the SURE-P/MCH programme had both supply and demand interventions and was implemented over 5 years in selected states in Nigeria. The paper adds new knowledge on demand and supply-side determinants of MCH services at the primary healthcare level. It provides information on the factors that affect provision and utilisation and then discusses how they may improve access to MCH services. Methods This qualitative study was undertaken in Anambra state, southeast Nigeria. Anambra state was purposively chosen because the SURE-P/MCH programme was implemented in the state. The Three-Delay model was used to analyze supply and demand aspects that affect MCH services and improve access to care for pregnant women/mothers and newborns/infants. Result The findings show that there were problems with both the demand and supply aspects of the programme and both were interlinked. For service users, their delays were connected to the constraints on the supply side. Conclusion There are some issues related to optimal supply and demand for MCH services within the programme that are important for improved programme design and implementation. Addressing the supply constraints would also improve problems with the demand for MCH services.