Developing A Conceptual Framework for Effective Dissemination and Implementation of Doula Support Service in Bayelsa State, Nigeria
Jimmy, Jessica Agada
*
Department of Maternal and Child Health Nursing, Faculty of Nursing Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
Wankasi, Helen Idubamo
Department of Community Health Nursing, Faculty of Nursing Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
Okoko, Tebekeme
Department of Biochemistry, Faculty of Basic Medical Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Maternal morbidity and mortality in Bayelsa State are worsened by gaps in culturally congruent companionship, communication, and psychosocial support across pregnancy, labour, and the postpartum period. Continuous, non-clinical support can improve women’s experiences and help mitigate the “three delays” in seeking, reaching, and receiving timely care.
Objective: To develop a conceptual framework to guide effective dissemination and implementation of doula support services in Bayelsa State, Nigeria.
Methods: Phase Two synthesised Phase One qualitative and quantitative findings. Concepts were classified using Dickoff et al.’s survey-list elements (agent, recipient, context, dynamics, process, and terminus) and then structured and described using Chinn and Kramer’s theory-generative steps.
Results: Agents comprised the State Ministry of Health, facility leadership, nurses, midwives, obstetricians, doula trainers/mentors, media, civil society organisations, and faith/women’s groups; recipients included pregnant/postpartum women, partners/families, and community influencers. The process specified sequential actions: policy development and adoption, professional endorsement, training and certification, facility integration, community dissemination, piloting with iterative scale-up, monitoring, and sustainability. Dynamics emphasised financing and logistics, government commitment, partnerships, communication, and cultural tailoring; intended outcomes were awareness, acceptability, adoption, fidelity, reduced delays, and improved maternal–neonatal indices. Long-term evaluation is essential.
Conclusion: The framework offers a pragmatic pathway for institutionalising doula services through coordinated, stakeholder-driven action and feedback-based improvement. Midwives should lead role clarification, supervise doulas, integrate supportive-care documentation into routine maternity workflows, and drive monitoring and quality-improvement cycles to embed respectful, woman-centred care at scale.
Keywords: Conceptual framework, dissemination, implementation, doula support service, Bayelsa State