Maternal Health Policy Implementation and Outcomes in Ebonyi State Primary Healthcare Centres

Maternal mortality remains one of the most pressing public health challenges in Ebonyi State, which consistently records among the highest rates in the South-East geopolitical zone of Nigeria. This study examines the implementation of maternal health policies in primary healthcare centres across Ebonyi State and assesses outcomes in terms of skilled birth attendance, antenatal coverage, and facility-based delivery rates. The study is anchored on the Implementation Framework by Van Meter and Van Horn, which conceptualises policy implementation as a function of resources, inter-organisational communication, implementing agency characteristics, and environmental conditions. A descriptive survey research design was employed. The population comprised nurses, community health extension workers, health centre managers, and pregnant women or recent mothers, from which 250 respondents were drawn using stratified random sampling across three senatorial zones. Structured questionnaires and focus group discussions provided primary data, analysed using regression analysis and descriptive statistics. Findings indicate that while antenatal care coverage has improved, facility-based delivery rates remain below national targets due to cultural preferences for traditional birth attendants, distance to centres, and frequent stockouts of essential drugs. The study concludes that maternal health policy implementation is constrained by resource insufficiency and sociocultural barriers. It is recommended that the state government intensify community health outreach, address drug supply chain gaps, and engage traditional birth attendants in structured referral partnerships with primary healthcare centres.

Keywords: Maternal Health, Policy Implementation, Primary Healthcare, Ebonyi State, Public Health