Maternal Care Systems Evaluation in Nigeria: A Bayesian Hierarchical Model for Clinical Outcomes Measurement

Maternal care systems in Nigeria have been pivotal for reducing maternal mortality rates. However, evaluating these systems remains challenging due to their complexity and variability. A longitudinal study employing a Bayesian hierarchical model was conducted. This approach allows for the assessment of multiple levels (individual patients to facility-level) simultaneously, capturing both within-facility and facility variability in clinical outcomes. The analysis revealed significant variation in clinical outcomes across different facilities, with one particular facility showing a reduction in neonatal mortality rates by 20% compared to the national average. The Bayesian hierarchical model provided robust estimates of clinical outcomes and effectively highlighted areas for improvement within the maternal care system. Facilities identified as underperforming should receive targeted support, including training programmes and resource allocation enhancements. Policy recommendations should focus on improving infrastructure and staff competence in these facilities. Maternal Care Systems, Nigeria, Bayesian Hierarchical Model, Clinical Outcomes, Neonatal Mortality Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.