title: Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria.
abstract: BACKGROUND
  Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care.
  
  
  OBJECTIVE
  To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria.
  
  
  METHODS
  Thirty-six hospital managers, heads of obstetrics department and senior midwives were interviewed about hospital infrastructure, resources, policies and processes relating to emergency obstetric care, whilst allowing informants to discuss their thoughts and feelings. The interviews were audiotaped, transcribed and analyzed using Atlas ti 6.2software.
  
  
  RESULTS
  Hospital managers are aware of the seriousness of maternal mortality and the steps to improve maternal healthcare. Many reported the lack of policies and specific action-plans for maternal mortality prevention, and many did not purposely disburse budgets or resources to address the problem. Although some reported that maternal/perinatal audit take place in their hospitals, there was no substantive evidence and no records of maternal/perinatal audits were made available. Respondents decried the lack of appropriate data collection system in the hospitals for accurate monitoring of maternal mortality and identification of appropriate remediating actions.
  
  
  CONCLUSIONS
  Healthcare managers are handicapped to properly manage the healthcare system for maternal mortality prevention. Relevant training of healthcare managers would be crucial to enable the development of strategic implementation plans for the prevention of maternal mortality.
authors.affiliation: Women's Health and Action Research Centre, Benin City, Edo State, Nigeria.|University of Medical Sciences, Ondo City, Ondo State, Nigeria.
authors.forename: Friday
authors.initials: F
authors.lastname: Okonofua
authors.affiliation: Ahmadu Bello University, Zaria, Kaduna State, Nigeria.
authors.forename: Abdullahi
authors.initials: A
authors.lastname: Randawa
authors.affiliation: University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Ogu
authors.affiliation: Central Hospital, Warri, Delta State, Nigeria.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Agholor
authors.affiliation: Karshi General Hospital, Federal Capital Territory, Abuja, Nigeria.
authors.forename: Ola
authors.initials: O
authors.lastname: Okike
authors.affiliation: Adeoyo Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: Rukayat Adeola
authors.initials: RA
authors.lastname: Abdus-Salam
authors.affiliation: General Hospital, Minna, Niger State, Nigeria.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Gana
authors.affiliation: Central Hospital, Benin City, Edo State, Nigeria.
authors.forename: Eghe
authors.initials: E
authors.lastname: Abe
authors.affiliation: General Hospital, Ijaye, Abeokuta, Ogun State, Nigeria.
authors.forename: Adetoye
authors.initials: A
authors.lastname: Durodola
authors.affiliation: Aminu Kano Teaching Hospital, Kano State, Nigeria.
authors.forename: Hadiza
authors.initials: H
authors.lastname: Galadanci
mesh_terms: D004632:Emergency Medical Services / Q000458:organization & administration*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D008880:Midwifery; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration*; D054238:Perinatal Mortality; D010820:Physicians; D011247:Pregnancy; D011787:Quality of Health Care / Q000458:organization & administration