TRENDS IN UTILIZATION OF OBSTETRIC CARE AT WESLEY-GUILD-HOSPITAL, ILESA, NIGERIA - EFFECTS OF A DEPRESSED ECONOMY

Perinatal mortality rate (PNMR) at Wesley Guild Hospital (WGH), Ilesa, Nigeria, over a ten-year period was retrospectively analysed. The mai n objective was to determine the trends in. the utilization of obstetr ic care and PNMR in the face of current economic difficulties in Niger ia and to make suggestions for improvement. The average PNMR over the period was 57.8/1000 births. There was a sharp rise in PNMR in 1985 to a peak of 110/1000 in 1987 (p<0.0001). This was associated with a dec line in utilization of maternity services, probably as a result of the introduction of fees for maternity services late in 1984 and increase in economic hardship in Nigeria. Actions are needed to improve enhanc ed access to obstetric care for the poor. These actions include: impro vement in the economic conditions of the people, emphasis on primary h ealth care (PHC) and early referral of high-risk pregnant women to ter tiary units.