A COMPARATIVE ANALYSIS OF THE IMPACT OF THE IMPLEMENTATION OF MATERNAL HEALTH POLICIES AND PROGRAMS ON THE UTILISATION OF MATERNAL HEALTH SERVICES AND MATERNAL OUTCOME IN THE SOUTHERN AND NORTHERN REGIONS OF NIGERIA
Maternal mortality is a major global public health issue; roughly 300,000 women die annually worldwide from pregnancy-related conditions. Approximately 99% of these deaths occur in developing countries. Nigeria which is one of the developing nations accounts for more than a tenth of maternal mortality rates globally. This poor maternal outcome in the country is said to be associated with poor utilization of maternal health services. Several efforts in forms of policies and programs have been made by the government to improve maternal outcome within the country and attain the MDG5 target. It is not clear the type and level of effect that the implementation of these maternal health policies and programs make on the utilization of maternal health services countrywide. This dissertation sets out to explore the major health policies and programs concerned with utilization of maternal health services, analyze the key factors influencing the implementation of these policies and programs and evaluate how the implementation of these policies and programs impacts the utilization of maternal health services and maternal outcome in various regions of the country. To achieve these objectives, a systematic desk review was carried out and the information gathered was analyzed using WHO health system building block framework. From the data analysis, the key findings revealed that amidst other policies and programs formulated to improve maternal health, the free maternal and child health service policy was a key policy implemented across the country. It was obvious from the analysis that communication gaps in policy formulation processes, resources, contextual factors, governance, among other factors influenced the implementation of these policies and programs countrywide. Despite these efforts, there is still a reasonable gap yet to be closed to meet the MDG5 target. Nonetheless, the maternal health system and utilization of maternal health services have improved in both regions of the country. With greater successes achieved in the south than the north of the country probably due to a higher political commitment by the southern government and deep structural factors distinct to the north. Following these findings, it is recommended that the government should focus on strengthening the maternal health system in the country taking into consideration contextual factors so as to achieve SDG3 targets.