A protocol to investigate predictors of healthcare workers’ responsiveness in initiating maternal and perinatal death reviews in secondary health facilities

Abstract

Maternal and perinatal mortality remain unacceptably high in sub-Saharan Africa, yet the systematic surveillance and response mechanisms designed to address them are poorly implemented in many low-resource settings. This research aims to investigate the predictors of healthcare workers’ responsiveness in initiating maternal and perinatal death surveillance and response (MPDSR) across selected secondary health facilities in Kebbi State, Nigeria. Despite global and national efforts to reduce maternal and perinatal mortality, Nigeria continues to experience high rates, with numerous secondary health facilities yet to fully implement MPDSR strategies. This study will adopt a cross-sectional design and will use a mixed-methods approach to explore factors influencing healthcare workers’ responsiveness. Stratified random sampling will be used to select 384 healthcare workers from 28 secondary health facilities. The data will be collected through structured questionnaires and focus group discussions with healthcare professionals, including nurses, midwives, and doctors. The study aims to identify predictors, such as facility capacity, healthcare workers’ knowledge, and training, related to the initiation of MPDSR. Findings from this study will provide evidence-based recommendations for policymakers to improve MPDSR implementation, reduce maternal and perinatal mortality, and enhance healthcare systems in Nigeria. The results will guide the formulation of targeted interventions to foster increased engagement and responsiveness among healthcare workers. Additionally, our protocol will assess the roles of organizational culture, facility infrastructure, and leadership support in shaping healthcare workers’ readiness to initiate MPDSR, thereby contributing to the broader evidence base on health system strengthening in low-resource settings.

Keywords

Healthcare workers’ responsiveness / Maternal and perinatal death reviews / Predictors of responsiveness / Secondary health facilities / Nigeria maternal mortality

References

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