| dc.description.abstract | Background: Maternal mortality is often described as the ‘tip of the iceberg’ with maternal morbidity as its base. However, little is known about how women perceive, seek care or are impacted by maternal morbidities, or about the prevalence of morbidities at community levels. Aim: To explore maternal morbidity within communities in Yola, Northern Nigeria in order to understand perceptions, care-seeking and measurement. Methods: Focus group discussions, in-depth interviews, family interviews, cognitive interviews and a household-based survey were conducted with married women who had delivered within the past two years. Results: In the qualitative studies, perceived morbidity status was the most dominant factor used to label a pregnancy as normal or difficult. Perceptions of morbidities were varied. While women acknowledged the severity of life-threatening conditions such as excessive bleeding, they also reported the impacts of less severe ones such as backache and vomiting. Morbidities were managed at home and/or through the formal system. The key drivers of care-seeking were mainly individual-level factors, with perceptions of severity and familiarity prominent. Women’s lay networks also influenced care-seeking positively or negatively. In the survey, high levels of health problems were reported. Spontaneous reporting of any health problem was 69.5%, 30.6% and 24.3% during pregnancy, delivery and postpartum respectively although few women reported that the health problems had been severe; on prompting, prevalence increased even more. The qualitative methods helped identify issues that could have affected the survey’s validity; however, reporting issues were also found. Conclusion: Maternal morbidity is a significant issue in the setting. Health problems that are important to women may not necessarily be the ones prioritised by public health. Exploring maternal morbidity in communities provides valuable insights that could have been missed in facility studies, but also has challenges. Measurement efforts would greatly benefit from using qualitative methods. | en_US |
