Understanding Antenatal Care in a Conflict State: Women's Experiences in Maiduguri, Nigeria

Abstract

Women who live in conflict-affected settings are more likely to die from preventable causes related to pregnancy and childbirth. In Maiduguri northeast Nigeria, conflict by the jihadi movement, Boko Haram, has resulted in the destruction of two-thirds of health care facilities in the wider region affected by the conflict, thereby increasing pressure on care delivery for pregnant women. This qualitative research addresses the question: What is the impact of the conflict in Maiduguri on the delivery of antenatal care services for women? Using an inductive content analytic approach, the study characterizes the conflict and antenatal care experiences of women in Maiduguri from the perspective of women themselves. Data consist of qualitative interviews 40 of women (> 18 years old) who attended or didn’t attend antenatal clinic, and ten key informants. Analysis of the interview data indicates women’s suffering has been exacerbated by the conflict, and that the response to the conflict has brought improvements to antenatal care services for women. Exacerbation of suffering includes increase in poverty, creation of physical hardship, and displacement. Experiences of improved antenatal care took the form of expressing appreciation of care, participants reporting service quality improvement, and women reporting increased motivation to seek care. The improvement to antenatal care is attributed to changes introduced by the humanitarian response to the conflict which now faces the question of sustainability for the future.