Assessment Of Health Seeking Behaviour Among Pregnant Women Attending Antenatal Clinic In Primary Healthcare In Okaka Community LGA Ilorin, Kwara State

Medical and Health Science Project and Seminar Material

Assessment Of Health Seeking Behaviour Among Pregnant Women Attending Antenatal Clinic In Primary Healthcare In Okaka Community LGA Ilorin, Kwara State


Abstract


This study is to determine the health seeking behaviour of pregnant women attending antenatal clinic in primary health care centres in Nnewi North Local Government area of Anambra State. A descriptive research design was utilized, and a well structured questionnaire was used as an instrument for data collection. A total of 110 respondents were used for the study. Results revealed that 81.82% of them suffered from malaria, excessive fatigue, swelling of feet and face, and 9.09% suffered malnutrition. Also majority of respondents (47.27%) were of the opinion that the health problems they face are pregnancy related, whereas a significant number (9.09%) opined that the causes of their health problems were as a result of curse from gods. Husbands’ decision (40.91%) and financial income (36.36%) were seen as the major factors influencing their health seeking behaviour. The researchers therefore recommended that an intensive community mobilization and health awareness programs should be done by health workers; also government should provide free antenatal care services for pregnant women and monitor its implementation.


Table of Content


Chapter One

Introduction

  • 1.1 Background to the Study
  • 1.2 Statement of the Problem
  • 1.3 Research Objectives
  • 1.4 Research Questions
  • 1.5 Significance of the Study
  • 1.6 Scope of the Study
  • 1.7 Limitations of the Study
  • 1.8 Definition of Terms
  • 1.9 Organization of the Study

Chapter Two:

Literature Review

  • 2.1 Conceptual Review
  • 2.1.1 Health and Health Seeking Behaviour
  • 2.1.2 Health Seeking Behaviour in Relation to Ante-natal Care(ANC)
  • 2.1.3 Classification of Health Seeking Behaviour
  • 2.1.4 Maternal Health Seeking Behaviour
  • 2.1.5 Factors Affecting Maternal Health Seeking Behaviour
  • 2.1.6 General Overview of Determinants of Maternal Health Care-Seeking Behaviour
  • 2.1.7 The Healthcare System in Nigeria
  • 2.1.8 Maternal Healthcare Services in Nigeria
  • 2.2 Theoretical Review
  • 2.2.1 Social Ecological Model of Health Promotion
  • 2.2.2 The Behavioural Model of Health
  • 2.3 Review of related Empirical Studies

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample and Sampling Technique
  • 3.4 Source for Data Collection
  • 3.5 Instrumentation of the Study
  • 3.6 Validation of the Instrument
  • 3.7 Reliability of the Instrument
  • 3.8 Method of Data Analysis

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Data Analysis
  • 4.3 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendations

  • 5.1 Summary of Findings
  • 5.2 Conclusion
  • 5.3 Recommendations
  • References
  • Appendix

Chapter One


Introduction

1.1 Background to the Study

The World Health Organization (WHO) defined health as the complete state of physical, mental and social well being, and not merely the presence or absence of disease or infirmity. Therefore, health seeking behaviour refers to all those things humans do to prevent diseases and detect diseases in their asymptomatic stages. In contrast, illness behaviour refers to all those activities designed to recognize and explain symptoms felt by an ill person and sick role behaviour refers to all those activities designed to cure diseases and restore health after a diagnoses has been made (Kraszewski, 2009). In Nigeria, women are said to be mothers of all, because they are usually the bearer of pregnancy, that is, the role of child bearing is traditionally assigned to them Ogunjuyigbe, 2000). Thus pregnancy is one of the most important events in the life of every woman and it is also a dynamic process in which a woman’s risk status can change at any point in time (WHO, 2000).

The utilisation of maternal healthcare services for antepartum, intrapartum, and postpartum care is one of the major approaches that can be used to improve maternal health (Ariyo et al., 2017). However, in sub-Saharan Africa there is still low utilisation of the services of skilled healthcare personnel (Sumankuuro et al., 2018). This is because some pregnant women do not deliver in the presence of skilled healthcare personnel due to economic, political, and sociocultural factors (Firoz et al., 2016). Despite global advancements in healthcare, some women within the reproductive age group patronise alternative maternity service providers because of the impact of some of the aforementioned factors. This has been attributed partly to the non-availability of other forms of maternity care services within their communities (James et al., 2018). It is also asserted that for people living in rural areas, who may not have reliable sources of income, alternative maternity care services are relatively more affordable (AmutahOnukagha et al., 2017). In Nigeria, pregnant women use the services of TBAs (traditional birth attendants), herbalists and spiritualists; this is a widespread practice among women in rural communities (Adedokun& Uthman, 2019). The low utilisation of the services of skilled healthcare personnel is classified, in part, as one of the factors that increase the risk of pregnancy-associated complications among women residing in remote or rural communities (Islam & Sultana, 2019; Sikder et al., 2014; Yahya &Pumpaibool, 2018). Although it is to be noted that pre-existing underlying health conditions, such as diabetics and chronic hypertension of the mother, can also increase complications in pregnancy, thereby affecting maternal health outcomes (Malcolm, 2012; Robledo et al., 2017).

Pregnant women can be said to be at risk of developing some health problems such as anaemia, fever, malaria, excessive fatigue, diarrhoea, reproductive tract infections, sexually transmitted infections, headache, backache, swelling, cramps (Chamberlain, 2001). These problems as stated may be as a result of either the pathological or physiological process or may also be as a result of deficiencies in the normal body constituents. Opinions towards the causes of these problems varies as they see their problems as either a result of traditional black magic (juju), or spiritual attack (witch craft), malnutrition whilesome others are under the group of ‘don’t know’ or ‘no opinion’ of the causes of the health problems in their pregnant state(Ogunjuyigbe and Ayotunde, 2007). These opinions of theirs’ tend to have effect on their health seeking behaviour


1.2 Statement of the Research Problem

In the recent years, health promotion programmes worldwide have been premised on the idea that providing knowledge about causes of ill health, choices and health care available. This had gone a long way towards promoting a change in individual behaviours towards more beneficial health seeking behaviours. However, owing to the difference in people’s opinion on where and when to seek health care services and also from the review of available literatures, it shows that no study has been carried out to determine the health seeking behaviour amongst pregnant women attending antenatal clinic in health centres in Anambra State, especially in Nnewi North. Thus the researchers decided to embark on this study.


1.3 Objective of the Study

The main objective of this study is assessment of health seeking behaviour among pregnant women attending antenatal clinic in primary healthcare in Okaka Community Lga Ilorin, Kwara State. Specifically, the family objectives were set to aid the researchers in carrying out this study.

  1. To determine the types of health problems experienced by pregnant women
  2. To ascertain their opinions towards the causes of their health problems.
  3. To find out the factors that influence their health seeking behaviour.
  4. To determine their opinion of suitable places to seek for health care.
  5. To identify their reasons of choosing those places for health care.

1.4 Research Questions

The following research questions are asked in this study:

  1. What determines the types of health problems experienced by pregnant women?
  2. What are the opinions towards the causes of their health problems?
  3. What are the factors that influence their health seeking behaviour?
  4. What Determines People’s opinion of suitablaces to seek for health care?
  5. What are the opinions of suitable places to seek for health care?

1.5 Significance of the Study

The result of this study will provide detailed information on the health seeking behaviour of pregnant women attending antenatal clinic in health care centres in Nnewi North Local Government Area of Anambra State, and this will be of benefit to the following:

  1. The pregnant women, as this will reveal their actual health seeking behaviour, such that they can be adequately be motivated and encouraged to develop better health seeking behaviours for their survival  The family will also benefit as complications in pregnancy affect not only the woman, but also the family, bringing sorrow, thus the need for a good health seeking behaviour.
  2. The community will also benefit as complications in pregnancy affect her and can lead to death of the pregnant woman, which will render the older children of the woman motherless and the husband, a widower. This affects the community negatively and depletes her economically as well.
  3. The policy makers will benefit from this as it will help them to plan effectively on how to combat the avoidable factors that militate against good health seeking behaviours amongst these women, such as reducing the cost of assessing health care services
  4. The health workers will also benefit as this will help them to effectively carryout campaign and actions on promoting good health seeking behaviour among these women through health education and rendering proper antenatal care services to them.

1.6 Scope of Study

This study is delimited to the pregnant women that attend antenatal clinic in health centres within Okaka Community LGA Ilorin, Kwara State.


1.7 Limitations of the Study

This study is limited to the pregnant women, family members and their husbands with respect to Kwara State. The study was constrained by time, availability of materials and financial constraints.


1.8 Definition of Terms

Maternal health-seeking behaviour:

Is defined in this study as the receipt of skilled antenatal care, antenatal care visits, having a health facility delivery and receiving skilled postnatal care.

Maternal health:

Health of women during pregnancy, childbirth and postpartum period

Maternal mortality:

Maternal mortality is defined according to World Health Organisation’s international classification of diseases. It is described as the death of a woman while pregnant or within 42 days of the termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (WHO, 1993).

Newborn death:

Death of a live born infant within the first 28 days of life Reproductive health: The state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes (ICPD, 1994). It implies that women are able to have a satisfying and safe sex life and have the capability to reproduce and the freedom to decide if, when and how often to do so. It also implies the right of women to have access to methods of family planning that are safe, effective, affordable and acceptable; and the right of access to appropriate health care.

Community:

Refers to the primary sampling unit (PSU) or clusters which are administratively defined areas and are important in research that involves policies (Antia, 2009). Primary sampling units are fairly homogeneous with respect to population sociodemographic characteristics and economic status; and are made up of one or more Enumeration Areas (EAs)


1.9 Organization of the Study

This study is categorised into five chapters and these include chapter one: background to the study, statement of the research problem, research objectives, research question, research hypotheses, significance of the study, scope and limitation of the study as well as definition of terms. Chapter two is classified into conceptual, theoretical and empirical reviews. Chapter three is the research methodology. This chapter comprises of the research design, population of the study, sample size and sampling technique, source and method of data collection, instrumentation of the study, method of data analysis, validity and reliability of the study.


Chapter Five


Summary, Conclusion and Recommendation

5.1 Summary

The following are major finding from data collected and analyzed;

  1. Majority of the respondents used for this study were between the ages of 20-29 years of age. v 82.73% (91) of the respondents used for this study were married but the percentage of teenage pregnancy was noted to be on a high side evidenced by it constituting 17.27% singles) of the population for the study.
  2. Most of the respondents used for the study were of Christian religion constituting 70.91% of the entire population for the study. v 80% of the respondents were housewives whom do nothing for a living but are dependent on their husbands.
  3. Also 45.55% of their husbands were artisan workers, 26.64% were traders, 8.18% were civil servants, 9.09 were farmers, 9.09% were jobless and 4.55% were truck pushers. (Hence can be said to be of a low income group). The health problems experienced by the respondents in the study were fever, malaria, excessive fatigue, vomiting, backache, swelling of the face and feet, malnutrition, anaemia, diarrhoea, abnormal vaginal discharge, blurred vision and abnormal cramps.
  4. Most of the respondents were of the opinion that these problems were just pregnancy related problem (47.27%), about 27.27% of them were of the opinion that its causes were unknown to them, 16.36% of them believe that it is a natural occurrence and 9.09% were of the opinion that it is a curse from the gods.
  5. The factors that influence their health-seeking behaviour from this study included finance which constituted 36.36%, distance of place18.18%, communication barriers 1.82%, husband’s decision 40.19%, and facilities in the health care centre 2.73%.
  6. 12.73% of the respondents used for this study were of the opinion to utilize herbalist as a place to seek for health care, 27.27% opined traditional birth attendants, 9.09% opined hospitals, 46.36% opined primary health care centre while 4.55%, opined religious homes /prayer houses.
  7. The respondents had the reason to their opinion as in above to be; they are effective (4.55%), distance to my home (1.82%), cheap cost (7.27%).

5.2 Conclusion

Based on the major findings, the researchers concluded that;

  1. Majority of the respondents (pregnant women) used for the study were between the ages of 20-29 years of age.
  2. Most of the respondents are housewives while majority are civil servants, farmers, engineers and bankers.
  3. From the findings, it can be deduced that most of the respondents experienced fever, malaria, excessive fatigue, vomiting, backache, swelling of the face and feet, as their health problems during pregnancy while some experienced malnutrition, anaemia, diarrhoea, abnormal discharge, blurred vision and abnormal cramps as their health problems.
  4. A greater number of the respondents opined that the causes of these problems are pregnancy related.
  5. It was found that the major factors influencing the health seeking behaviour of the respondents are their husbands, followed by finance
  6. Majority of the respondents utilize primary health care centers as a place to seek for health care, few utilize hospitals and traditional birth attendants, while others utilize herbalist.
  7. Greater number of the respondents chose where to seek for health care because they feel the services/care rendered there are effective and cheap.
  8. Also, it is noted that teenage pregnancy was on effective education and counselling of women on the importance of antenatal care: emphasizing that it is cheap.
  9. Government should ensure that antenatal care services are affordable, especially at the grass root.
  10. Government should grant a policy on women empowerment to enable them take decision of their health problem especially in pregnancy.
  11. Public health campaign on the importance of healthy pregnancy, problems in pregnancy and where to get care.

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