Nurses’ Role in Prevention of Infant and Under-five Child Mortality in Africa
CHAPTER ONE
OBJECTIVES OF STUDY
- To examine if nurses in Bauchi State provide effective ante natal care.
- To examine if nurses in Bauchi State improve care for women in labour satisfactorily.
- To examine if nurses in Bauchi State treat obstetrics emergency satisfactorily.
- To examine if nurses in Bauchi State provide care for women at pueperium satisfactorily.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Framework
Infant And Child Mortality
Child mortality rate also known as under-five mortality rate is defined as the possibility that in every 1000 live births one baby will die before reaching age five: Whereas, the death of a child before his/her first birth day is termed infant death or infant mortality. Therefore, infant mortality rate is the number of chil- dren dying under a year of age by 1000 live births. Infant mortality rate is an important marker to measure the health and wellbeing of a population (Centre for disease control and prevention, 2014). This is because it is often linked to several factors such as maternal health, quality and access to medical care, socioeconomic conditions, and public health practices (Definition of Mortality, Infant, 2012).
In 2013, an estimated 6.3 million children under five years of age depart this life. An estimated 44% of these deaths occurred during the neonatal period. Neonatal period, which is the first 28 days of life, is considered to be the time where in a child is at the highest risk of dying. In addition, about 45% of all the under-five death has a connection with malnutrition. Although a child born in an already developed or a developing country can die before five years of age, he/she is, however, more likely to die if living in sub-Saharan Africa and Southern Asia compared to his/her counterparts in a developed country.
About 50% of all under- five deaths occur in only five developing countries namely China, Democratic Republic of the Congo, India, Nigeria and Pakistan. (Children: Reducing Mortality, WHO, 2014). A large proportion of these deaths are caused by infectious yet preventable diseases (Niño-Zarazúa, 2013)
Causes Of infant mortality
According to the WHO (2000), “A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.” Generally there is a distinction between a direct maternal death that is the result of a complication of the pregnancy, delivery, or their management, and an indirect maternal death that is a pregnancy-related death in a patient with a pre-existing or newly developed health problem. Other fatalities during but unrelated to a pregnancy are termed accidental, incidental, or non obstetrical maternal deaths (Wikepedia,2006).
CHAPTER THREE
RESEARCH METHODOLOGY
RESEARCH DESIGN
As the purpose of this study was to asses the role of nurses in reducing infant mortality in Bauchi state. Ex-post facto research design was used because the information required to achieve the purpose was already available to collect the information required to answer the research questions.
Information on role of nurses on the provision of effective ante natal care during pregnancy, skilled care at birth, care of women at pueperium, and treatment of obstetric emergencies in Bauchi state were search for and recorded.
POPULATION
The population of this study consisted of nurses employed in the local government health centers, maternities/state hospitals, and mothers attending these clinics for maternity care in Bauchi state. The state had 17 functional general hospitals (one of which is a specialist hospital), 75 primary health centers, 50 maternity clinics at the time this study was conducted.
SAMPLE AND SAMPLING TECHNIQUE
Stratified and random sampling techniques were used in this study, Bauchi state was divided into three senatorial zones, which constitute stratum for the purpose of this study., two Local Government Areas {LGA}, were randomly selected from each stratum.
The respondents selected from each of the health institutions were based on the number of target population.
In each of the local government selected, there were 87 respondents of the study comprising 27 nurses and 60 clients (mothers with pregnancy related cases) attending the health facilities. A standardized questionnaire on the role of nurses on infant mortality in Bauchi state was administered on all the Five hundred and twenty two respondents.
CHAPTER FOUR
RESULTS AND DISCUSSION
Socio-Demographic Data Of Respondents
General discussions on the basis of the hypotheses are presented in the subsequent sections of the chapter.
Table 4.1 (a) shows that out of the 303 maternity clients respondents, more than 42% were between the ages 20 -29 years of age, 32% were between the ages of 30-39 years of age, and 14% were between the ages of 40-49 years of. About 76% were married, 51% attended primary school, 26% attended secondary school.52% of the respondents were clients from General / specialist hospitals and 27% from maternity homes.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
CONCLUSION
The conduct of nurses contribute significantly to the provision of effective ante natal care, which results in the reduction of infant mortality.
The nurses provide significant skilled attendance at birth which ensures safe delivery and prevents delivery complications and thus directly reduces infant mortality.
The nurses provide obstetric emergency care which significantly prevents ante natal, natal, and post natal morbidity that may result in infant mortality.
The nurses provide care to women at pueperium, including puerperal sepsis, which put into controls puerperal complications that may result in women’s death, which is a positive influence in the reduction of infant mortality.
RECOMMENDATIONS
On the basis of the findings of this study, the following recommendations are made for effective and efficient provision of maternity care by nurses in Bauchi State.
The State governments and local government, whose responsibility is to provide facilities and equipment for the efficient and effective running of skilled care acquired by nurses, should do so adequately and timely based on WHO recommendations to help reduce infant mortality.
The State and local governments should ensure adequate provision of nurses to cater for the needs of the citizens.
The State and local governments should ensure staff remunerations that will prevent the attrition of the skilled care trained nurse and midwives, as their contribution to the prevention of under-five mortality are very positive.
The State and local governments should ensure retraining of the already trained midwives and nurses on a continuous basis.
The State and local governments should ensure adequate and constant supervision; monitoring and evaluation of the activities of nurses to make their work more efficient.
Communities should be mobilize through community leaders/traditional rulers, such village heads, district heads, and clergy men and women, school teachers, students, village health committees In order for women reap the benefits of skilled care.
The State and local governments should ensure health education and public enlightment to the communities about the contribution of nurses to maternity services.
REFERENCES
- Adeyemi,A. A, Ojengbede O. A, Madina E. K, Odeku M. A. (2005): Training manual on life saving skills for nurses, publish by Federal ministry of health, WHO, Nigeria Partnership for Transforming Health system (PATH), and Department for International Development (DFID).
- Anthony, A. (2006), Conducting Research in Educational and the Social Sciences, Publish by Tashiwa Networks Ltd.
- Attah, B.E. (2000): Human pathology, a complete text for Africa (First edition) Ibadan, University Press, Ibadan.
- Bauchi State, Ministry of Health, (2007); Syndicate Exercise.
- Belhocine, M. (2003), Training manual on Emergency Obstetric care (As an expanded Life Saving Skills (skilled care) for doctors), publish by World Health Organisation and Federal Government of Nigeria.
- Ben, A. (2006), Coalition for Health Sector Reform (HSR): A vehicle for achieving the mellinium development goals, a paper presentation at interactive workshop between the federal ministry of health and the national association of Nigerian nurses,2nd-5th ,Otober, 2006.
- Colombo (1997), the safe motherhood technical consultation http:// www.who. Int/nursing.
- Dekker G, Sibai B (2001), Primary, Secondary, and Tertiary prevention of pre- eclampsia. Lancet 357: 209-215.
