Assessment Knowledge Causes And Prevention Of Stillbirth Among Women Of Childbearing Age

Project and Seminar Material for Nursing (Science)

Assessment Knowledge Causes And Prevention Of Stillbirth Among Women Of Childbearing Age (Obong)

Abstract

This study focused on the assessment knowledge causes and prevention of stillbirth among women of childbearing age using women attending gynecological clinic at specialist hospital Enugu as case study.. The study is was specifically focused on determining socio-economic factors associated with the occurrence of stillbirths among women of childbearing age, determining maternal factors associated with the occurrence of stillbirths among women of childbearing age, identifying health-system factors associated with the occurrence of stillbirths among women of childbearing age and identifying knowledge factors associated with the occurrence of stillbirths among women of childbearing age. The study adopted the survey research design and randomly enrolled participants in the study. A total of 387 responses were validated from the enrolled participants where all respondent are women attending gynecological clinic at specialist hospital Enugu.

Table of Content

Title Page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
Abstract

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Limitation of the Study
1.9 Definition of Terms
1.10 Organisations of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background to the Study

Stillbirth, the tragic loss of a fetus after 20 weeks of gestation, remains a significant global public health concern, with profound emotional and societal consequences. In the context of Nigeria, where maternal and child health challenges persist, understanding the causes and implementing effective prevention strategies is paramount. This introduction will delve into the multifaceted aspects of stillbirth, shedding light on the specific challenges faced by women of childbearing age in Nigeria.

Stillbirth rates vary across regions, but Nigeria bears a considerable burden. According to a comprehensive study by Aminu et al. (2017), the stillbirth rate in Nigeria is estimated to be 42 per 1000 births, indicating a critical need for focused attention on this issue.

There may be higher rates of stillbirths occurring across the world since the captured figures are mere estimates due to poor reporting systems (Reinebrant et al., 2017). Developing countries have higher rates of stillbirths as compared to developed countries with significant variations between countries. The rate of stillbirths in developing countries is 25.5/1000 births with sub-Saharan Africa having the highest rates of 32.2/1000 followed by South Asia 31.9/1000 births respectively (Stanton et al., 2012).

High rates of stillbirths in developing countries were associated with lack of access to good-quality obstetric care, resulting in intrapartum deaths (Blencow et al., 2016). Stillbirths are associated with lack of access to skilled birth attendant, poor nutritional status, advanced maternal age and low socioeconomic status. Other factors include pregnancy complications, use of harmful drugs, delivery complications and delayed caesarean section (Neogi et al., 2016). Despite systems in place to classify and report stillbirths, it is challenging to determine the exact cause of the stillbirth.

Maternal health plays a pivotal role in preventing stillbirths. In Nigeria, challenges such as limited access to quality antenatal care, skilled birth attendants, and family planning services contribute significantly to adverse pregnancy outcomes (Ononokpono & Odimegwu, 2015).
Infections, particularly during pregnancy, are known contributors to stillbirth. Malaria, syphilis, and other infectious diseases are prevalent in Nigeria and have been associated with a higher risk of stillbirth (Mbah et al., 2017). Understanding the interplay between these infections and stillbirth is crucial for tailored prevention strategies.

Maternal malnutrition is another factor influencing stillbirth rates. A study by Ota et al. (2015) highlights the significance of proper maternal nutrition in reducing the risk of adverse pregnancy outcomes. In Nigeria, where malnutrition remains a concern, addressing this aspect is pivotal for preventive interventions.

Socioeconomic factors, including poverty and limited access to education, can impact maternal health and contribute to stillbirth. Efforts to alleviate poverty and improve educational opportunities for women are integral components of comprehensive stillbirth prevention strategies (Fagbamigbe et al., 2017).

Strengthening healthcare infrastructure is essential for preventing stillbirths. Adequate facilities, skilled healthcare providers, and accessible emergency obstetric care are critical elements. Addressing these challenges requires a comprehensive approach involving governmental initiatives, community engagement, and international collaboration (Izugbara et al., 2018).

Therefore, the causes of stillbirth among women of childbearing age in Nigeria are complex and multifaceted. This study will provide a glimpse into the various factors contributing to stillbirth and highlights the urgent need for targeted interventions. The study will delve deeper into each aspect, offering a comprehensive understanding of the challenges and potential solutions to mitigate the prevalence of stillbirth in Nigeria.

1.2 Statement of the Problem

Stillbirth remains a significant public health challenge in Nigeria, with a reported stillbirth rate of 42 per 1000 births (Aminu et al., 2017). Despite global efforts to improve maternal and child health, the causes and prevention of stillbirth among women of childbearing age in Nigeria continue to present complex and inadequately understood issues. There is a lack of in-depth understanding of the specific causes of stillbirth in Nigeria. While studies have highlighted broad factors such as maternal health disparities, infectious diseases, and nutritional deficiencies (Ononokpono & Odimegwu, 2015; Mbah et al., 2017; Ota et al., 2015), there is a need to explore the nuanced interplay of these factors in the Nigerian context.

Maternal health disparities persist, and access to quality antenatal care and skilled birth attendants remains a challenge in many regions of Nigeria (Ononokpono & Odimegwu, 2015). Understanding the specific barriers to healthcare access and their contribution to stillbirth is crucial for effective preventive strategies.

The prevalence of infectious diseases, such as malaria and syphilis, raises concerns about their role in stillbirth within the Nigerian population (Mbah et al., 2017). Further investigation is needed to delineate the specific impact of these infections and develop targeted interventions.

Maternal malnutrition is identified as a contributing factor to stillbirth (Ota et al., 2015). However, there is a gap in understanding the prevalence of nutritional deficiencies among pregnant women in Nigeria and their direct correlation with stillbirth.

Socioeconomic factors, including poverty and limited education, are linked to adverse pregnancy outcomes (Fagbamigbe et al., 2017). Examining the role of these determinants and formulating context-specific preventive strategies are crucial for reducing stillbirth rates.

The existing healthcare infrastructure in Nigeria faces challenges in providing adequate maternal and obstetric care, which may contribute to stillbirth (Izugbara et al., 2018). Investigating these challenges and proposing improvements are essential for effective preventive measures.

Addressing these gaps in knowledge will contribute to a comprehensive understanding of the causes and prevention of stillbirth among women of childbearing age in Nigeria, providing a foundation for evidence-based interventions and policy recommendations.

1.3 Objective of the Study

The main objective of the study is an assessment knowledge causes and prevention of stillbirth among women of childbearing age. The specific objectives of the study are;

To determine socio-economic factors associated with the occurrence of stillbirths among women of childbearing age.
To determine maternal factors associated with the occurrence of stillbirths among women of childbearing age.
To identify health-system factors associated with the occurrence of stillbirths among women of childbearing age.
To identify knowledge factors associated with the occurrence of stillbirths among women of childbearing age.

1.4 Research questions

This study sought to answer the following research questions;

What are the socio-economic factors associated with the occurrence of stillbirths among women of childbearing age?
What are the maternal factors associated with the occurrence of stillbirths among women of childbearing age?
What are the health-system factors associated with the occurrence of stillbirths among women of childbearing age?
What are the knowledge factors associated with the occurrence of stillbirths among women of childbearing age?

1.5 Hypothesis of the study

H0: Socio-economic, maternal, health-system and knowledge factors are not associated with the occurrence of stillbirths among women of childbearing age.

1.6 Significance of the Study

Understanding the causes and prevention of stillbirth among women of childbearing age in Nigeria holds substantial significance due to its far-reaching implications for public health, maternal well-being, and societal development. The outcomes of this study are anticipated to contribute to the following areas of significance.

The study’s findings can significantly contribute to the enhancement of public health initiatives in Nigeria. By identifying specific causes of stillbirth and formulating evidence-based preventive strategies, the study can inform healthcare policies aimed at reducing stillbirth rates and improving overall maternal and child health.

Unraveling the nuanced causes of stillbirth in the Nigerian context allows for the identification of high-risk groups. This information is crucial for the development of targeted interventions and support systems, ensuring that vulnerable populations receive focused attention and resources.

The study’s insights can directly impact the well-being of mothers and their children by contributing to the reduction of stillbirth rates. By addressing specific factors such as maternal health disparities, infectious diseases, and nutritional deficiencies, interventions can be designed to improve pregnancy outcomes, promoting healthier mothers and infants.

Healthcare providers play a pivotal role in maternal care. The study’s findings can provide valuable guidance to healthcare professionals by offering a deeper understanding of the multifaceted causes of stillbirth. This knowledge can inform clinical practices, enabling more targeted and effective antenatal care and interventions.

Policymakers can use the study’s results to formulate evidence-based policies addressing the root causes of stillbirth in Nigeria. These policies can encompass improvements in healthcare infrastructure, increased accessibility to quality maternal care, and targeted interventions to address specific risk factors.

The study’s dissemination of knowledge can contribute to increased community awareness regarding the causes and prevention of stillbirth. Education campaigns can empower communities with information to make informed decisions about maternal healthcare, emphasizing the importance of early antenatal care and adherence to preventive measures.

The study’s findings can foster collaboration between Nigeria and the international community in addressing stillbirth. Shared knowledge and experiences can lead to the development of collaborative interventions, drawing on successful strategies implemented in other regions with similar challenges.

The societal and economic burden associated with stillbirth, including emotional distress and healthcare costs, can be alleviated through effective prevention strategies. By reducing the incidence of stillbirth, the study can contribute to minimizing these burdens, fostering a healthier and more productive society.

This study’s significance lies in its potential to inform targeted interventions, policies, and awareness campaigns that can effectively reduce stillbirth rates among women of childbearing age in Nigeria, ultimately improving maternal and child health outcomes and contributing to broader public health goals.

1.7 Scope of the Study

The study was carried out in Post delivery clinics of the four selected hospitals in Enugu Metropolis. The study was bound to all sampled respondents who delivered in the selected facilities within the past few months. This offered the researcher an opportunity to assess respondents‟ experiences and factors associated with their delivery outcomes. These study results are only generalizable to other Enugu state health facilities.

1.8 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

1.9 Definition of Terms:

Stillbirth:

Stillbirth refers to the delivery of a baby showing no signs of life after 20 weeks of gestation or with a birth weight of 500 grams or more. It represents a devastating outcome of pregnancy with significant emotional and medical implications for the affected individuals and their families.

Maternal Health Disparities:

Maternal health disparities denote inequities in the access to and quality of healthcare services for pregnant women. These disparities can manifest as differences in antenatal care utilization, skilled birth attendance, and overall maternal healthcare outcomes among different socioeconomic or demographic groups.

Infectious Diseases:

Infectious diseases in the context of this study refer to illnesses caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi, which can adversely affect the health of pregnant women and contribute to stillbirth. Common examples include malaria, syphilis, and other infections that may be prevalent in the Nigerian population.

Nutritional Deficiencies:

Nutritional deficiencies pertain to inadequate levels of essential nutrients required for optimal health during pregnancy. In the context of this study, it includes insufficient intake of vital nutrients like folic acid, iron, and other micronutrients, which may contribute to adverse pregnancy outcomes, including stillbirth.

Socioeconomic Determinants:

Socioeconomic determinants refer to the social and economic factors influencing health outcomes. In the context of stillbirth, these determinants encompass variables such as income, education, employment, and living conditions, which can impact maternal health and contribute to the risk of stillbirth.

Healthcare Infrastructure:

Healthcare infrastructure encompasses the facilities, personnel, and resources available within a healthcare system. In the context of stillbirth prevention, it refers to the quality and accessibility of healthcare services, including antenatal care, skilled birth attendance, and emergency obstetric care facilities.

1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusions and Recommendations

5.1 Introduction

This chapter summarizes the findings on the assessment knowledge causes and prevention of stillbirth among women of childbearing age using women attending gynecological clinic at specialist hospital Enugu as case study. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was on the assessment knowledge causes and prevention of stillbirth among women of childbearing age using women attending gynecological clinic at specialist hospital Enugu as case study.. The study is was specifically focused on determining socio-economic factors associated with the occurrence of stillbirths among women of childbearing age, determining maternal factors associated with the occurrence of stillbirths among women of childbearing age, identifying health-system factors associated with the occurrence of stillbirths among women of childbearing age and identifying knowledge factors associated with the occurrence of stillbirths among women of childbearing age.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 387 responses were validated from the enrolled participants where all respondent are women attending gynecological clinic at specialist hospital Enugu.

5.2 Conclusions

The study analyzed all the significant results and came up with the following conclusions.

Advanced age of the mother, low level of education attained, low monthly income was significantly associated with still birth delivery outcome.
The maternal factors that significantly influenced stillbirth delivery outcome among respondents included; utilization of antenatal care services, use of illicit drugs, low maternal weight and exposure to tough domestic work.
The health system factors that were of importance in predicting occurrence of delivery outcomes was accessibility which included; long distance to the health facility, high cost of transport, not having medical insurance cover, and inadequate provision of health information.
The study findings showed that there were low knowledge levels among respondents regarding how they managed their pregnancy and delivery outcomes. The mothers were not aware of what predisposes a pregnant woman to stillbirth delivery.

5.3 Recommendations

The relevant NGOs and the county government should empower women through creation of conducive environment for income- generating activities so that they can be able to improve their family income thus increased utilization of health services.
The Ministry of Health together with relevant stakeholders should champion for campaigns aimed at sensitizing pregnant mothers on the importance of attending to antenatal care clinics. At the clinics the mothers to advised on their nutrition during pregnancy.
The ministry of health, national and county government should come up with mobile clinics to improve access to health facilities among the far to reach areas. This will ensure the use of reproductive health services during pregnancy and eventual delivery.
The ministry of health, county government, NGOs and relevant stakeholders should ensure the creation of sensitization predisposing factors to stillbirth delivery outcome.