title: Systematic review of obstetric care from a women-centered perspective in Nigeria since 2000.
abstract: BACKGROUND
  A women-centered approach can improve the quality of patient care.
  
  
  OBJECTIVE
  To review issues in the provision of obstetric care from a patient-centered care perspective in Nigeria.
  
  
  METHODS
  Using terms related to maternal and perinatal mortality, in combination with "Nigeria", MEDLINE, Embase, CINAHL, Web of Knowledge, and African Journal Online were searched, between December 1, 2013 and January 31, 2014, for articles in any language.
  
  
  METHODS
  Articles published in a Nigerian setting after 2000 that investigated causes of and circumstance surrounding maternal deaths and complications, or clinical practice related to maternal care were included.
  
  
  METHODS
  Data were extracted by two reviewers using a standardized abstraction form and were analyzed from a patient-centered perspective.
  
  
  RESULTS
  The analysis included 57 studies. Clandestine induced abortions, lack of prenatal care, delays in seeking care, and the use of spiritual churches for delivery were found to contribute to adverse pregnancy outcomes.
  
  
  CONCLUSIONS
  Healthcare systems respond inadequately to patients' needs in terms of abortion care, information sharing, transitioning between prenatal and obstetric care, and patients' non-medical needs. Data from clinician-led maternal death audits provided insights into how women-centered care can be provided; nonetheless, more-focused studies from a primarily patient-centered perspective are warranted.
authors.affiliation: Immpact, University of Aberdeen, Aberdeen, Scotland, UK.
authors.forename: Atsumi
authors.initials: A
authors.lastname: Hirose
authors.affiliation: Women's Health and Action Research Centre (WHARC), Benin City, Edo State, Nigeria.
authors.forename: Oluwatoyin
authors.initials: O
authors.lastname: Owolabi
authors.affiliation: Immpact, University of Aberdeen, Aberdeen, Scotland, UK.
authors.forename: Mari
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Women's Health and Action Research Centre (WHARC), Benin City, Edo State, Nigeria.
authors.forename: Friday
authors.initials: F
authors.lastname: Okonofua
authors.affiliation: Immpact, University of Aberdeen, Aberdeen, Scotland, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Hussein
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D002423:Cause of Death; D003695:Delivery of Health Care / Q000592:standards*; D003906:Developing Countries; D005260:Female; D006801:Humans; D063130:Maternal Death / Q000706:statistics & numerical data* / Q000639:trends; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000592:standards*; D012067:Religion
keywords: Abortion; Audits; Confidential enquiries; Maternal deaths; Nigeria; Prenatal care; Reviews; Spiritual churches