THE ROLE OF COMMUNITY NURSES IN REDUCING MATERNAL MORTALITY IN RURAL SOKOTO STATE (2020–2024)

THE ROLE OF COMMUNITY NURSES IN REDUCING MATERNAL MORTALITY IN RURAL SOKOTO STATE (2020–2024)

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study

Maternal mortality remains a major public health concern globally, particularly in sub-Saharan Africa where over two-thirds of maternal deaths occur. In Nigeria, maternal mortality ratios are among the highest in the world, with rural regions like Sokoto State facing disproportionate burdens due to limited healthcare access, cultural practices, and inadequate healthcare infrastructure (WHO, 2023). Community nurses serve as a critical component of the healthcare delivery system in these underserved areas. Their proximity to rural populations and their ability to deliver essential maternal and child health services have positioned them as vital actors in the effort to reduce maternal mortality (FMoH, 2022).

In Sokoto State, maternal deaths are often the result of preventable causes such as hemorrhage, sepsis, hypertensive disorders, and complications from unsafe abortions. These deaths are exacerbated by delays in seeking care, reaching appropriate facilities, and receiving adequate treatment. Community nurses bridge these gaps by offering antenatal care, health education, skilled birth attendance, postnatal services, and referrals to higher-level care facilities. Their role extends beyond clinical services to encompass community engagement, behavior change communication, and advocacy for maternal health rights (Okafor & Arikpo, 2021).

The implementation of various national health programs such as the Midwives Service Scheme (MSS) and the Primary Health Care Under One Roof (PHCUOR) framework has expanded the deployment and capacity of community nurses across rural Nigeria. In Sokoto State, community-based nursing interventions have been aligned with state-level maternal health initiatives aimed at achieving Sustainable Development Goal 3 (SDG 3), which targets a reduction in the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 (UNDP, 2023).

Despite these efforts, empirical evidence on the specific contributions of community nurses in rural Sokoto remains limited. A comprehensive analysis of their roles, challenges, and the outcomes of their interventions is essential for evaluating the effectiveness of current maternal health strategies and informing future policy and practice. This study, therefore, aims to examine the role of community nurses in reducing maternal mortality in rural Sokoto State between 2020 and 2024.

1.2 Statement of the Problem

Nigeria continues to report high maternal mortality figures, with northern rural states like Sokoto accounting for a substantial share. While interventions have been initiated to combat these trends, maternal health indicators remain poor. The persistent high maternal mortality rate in Sokoto suggests a gap between health policy implementation and on-ground healthcare delivery. One area that has received insufficient scholarly attention is the role of community nurses in mitigating this public health crisis.

Community nurses operate at the grassroots level, making them uniquely positioned to provide maternal health services that are both culturally sensitive and accessible. However, there is a paucity of data assessing their real impact on maternal mortality rates in rural communities of Sokoto. It is unclear to what extent these nurses influence maternal health outcomes, what specific services they render, and how socio-cultural, logistical, and institutional barriers affect their performance.

This research seeks to fill this gap by evaluating the functions and contributions of community nurses in reducing maternal mortality in Sokoto State between 2020 and 2024. It will assess their reach, efficiency, challenges faced, and the outcomes of their interventions within the rural healthcare landscape.

1.3 Objectives of the Study

To examine the roles played by community nurses in delivering maternal healthcare services in rural Sokoto State.

To evaluate the impact of community nursing services on maternal mortality rates from 2020 to 2024.

To identify the challenges faced by community nurses in providing maternal healthcare in rural areas.

1.4 Research Questions

What roles do community nurses play in maternal health service delivery in rural Sokoto?

How have community nursing interventions affected maternal mortality rates between 2020 and 2024?

What are the major challenges community nurses face in reducing maternal mortality?

1.5 Research Hypotheses

H₀₁: There is no significant relationship between community nursing interventions and maternal mortality rates in rural Sokoto.

H₀₂: The challenges faced by community nurses do not significantly affect their ability to reduce maternal mortality.

1.6 Significance of the Study

This study is significant to multiple stakeholders, including healthcare policymakers, maternal health practitioners, and nursing institutions. For policymakers, it provides evidence-based insights to refine and strengthen community health strategies. For healthcare workers, particularly nurses, it highlights best practices and identifies systemic barriers requiring redress. Additionally, it contributes to academic literature by offering empirical findings on the contributions of community nursing to maternal health outcomes in rural Nigeria. The study will also help to improve planning and resource allocation for rural health services.

1.7 Scope and Limitation of the Study

The study is geographically limited to rural areas of Sokoto State and temporally focused on the period from 2020 to 2024. It concentrates on community nurses working in public health institutions under the primary health care system. Limitations include possible bias in self-reported data from health personnel and the difficulty in obtaining accurate maternal mortality records in remote locations.

1.8 Operational Definition of Terms

Community Nurses: Trained health professionals who provide primary and maternal healthcare services within community settings, especially in rural areas.

Maternal Mortality: Deaths of women during pregnancy, childbirth, or within 42 days of termination of pregnancy due to complications related to pregnancy or childbirth.

Rural Areas: Remote or less-developed parts of Sokoto State with limited access to urban healthcare facilities.

1.9 Structure of the Study

This study comprises five chapters. Chapter One introduces the study. Chapter Two reviews relevant literature and theoretical frameworks. Chapter Three outlines the methodology used. Chapter Four presents the data analysis and interpretation. Chapter Five concludes the study with a summary, conclusions, and recommendations.

References

Federal Ministry of Health (FMoH). (2022). National health policy review. Abuja: FMoH.

Okafor, C. J., & Arikpo, I. (2021). Role of community health nurses in maternal and child health: A Nigerian perspective. African Journal of Nursing, 14(2), 115–124.

United Nations Development Programme (UNDP). (2023). SDG progress report: Nigeria. New York: UNDP.

World Health Organization (WHO). (2023). Maternal mortality global estimates 2023. Geneva: WHO.