Obstetric knowledge of nurse-educators in Nigeria: Levels, regional differentials and their implications for maternal health delivery

Abstract

Objective: To assess the knowledge of nurse-midwife educators on the major causes of maternal mortality in Nigeria. Setting: Schools of nursing and midwifery in Nigeria. Method: A total of 292 educators from 171 schools of nursing and midwifery in Nigeria were surveyed for their knowledge of the major causes of maternal mortality as a prelude to the design and implementation of a train-the-trainer intervention geared towards improved maternal health-care delivery. Results: There was paucity of knowledge across all major causes. Only 57.2% and 62.7% of educators could diagnose pre-eclampsia and severe pre-eclampsia, respectively. While 86% knew about magnesium sulphate (MgSO4) as the ‘gold standard’ for treating eclampsia, only 16.8% knew of calcium gluconate as an antidote to MgSO4 toxicity. Of the educators, 63.7% could not describe the components of active management of third stage of labour, while 29.5% were not aware of uterine atony as a cause of postpartum haemorrhage. Furthermore, 65.4% believed that misoprostol is the preferred oxytocic for hospital delivery. Other potentially harmful knowledge gaps were also found, such as 47.3% of the participants reporting that they would perform episiotomies on all primigravidae. Conclusion: Nurse/midwife educators in Nigeria are not as knowledgeable as previously thought, especially concerning the causes of maternal mortality. In order to scale up the quality of obstetric care, updated pre-service curricula should be implemented fully while in-service appraisal and continuing education should be introduced.