Obstetric knowledge of nurse educators in Nigeria: Levels, regional differentials and their implications for maternal health delivery
Objective: To assess the knowledge of nurse midwife educators on the major causes of maternal mortality in Nigeria. Setting: Schools of nursing and midwifery in Nigeria. Method: A total of 292 educators from 171 schools of nursing and midwifery in Nigeria were surveyed for their knowledge of the major causes of maternal mortality as a prelude to the design and implementation of a train the trainer intervention geared towards improved maternal health care delivery. Results: There was paucity of knowledge across all major causes. Only 57.2% and 62.7% of educators could diagnose pre eclampsia and severe pre eclampsia, respectively. While 86% knew about magnesium sulphate (MgSO4) as the 'gold standard' for treating eclampsia, only 16.8% knew of calcium gluconate as an antidote to MgSO4 toxicity. Of the educators, 63.7% could not describe the components of active management of third stage of labour, while 29.5% were not aware of uterine atony as a cause of postpartum haemorrhage. Furthermore, 65.4% believed that misoprostol is the preferred oxytocic for hospital delivery. Other potentially harmful knowledge gaps were also found, such as 47.3% of the participants reporting that they would perform episiotomies on all primigravidae. Conclusion: Nurse/midwife educators in Nigeria are not as knowledgeable as previously thought, especially concerning the causes of maternal mortality. In order to scale up the quality of obstetric care, updated pre service curricula should be implemented fully while in service appraisal and continuing education should be introduced.