Assessment Of Reproductive Healthcare Services For Women

Project and Seminar Material for Sociology

Assessment Of Reproductive Healthcare Services For Women


Abstract


The major objective of this research was to examine the problems and prospects of women and access to reproductive healthcare services in Dutsin-Ma local government area of Katsina State. The study was hinged on four major objectives which were to ascertain the state of women reproductive services, determine whether women have access to reproductive healthcare services, Identify the challenges facing women access to reproductive healthcare services and Suggest ways that can enhance women access to reproductive healthcare services in Dustin-Ma local government area. Andersen Health Behavioural Model was used as the major theoretical framework to explain women access to reproductive healthcare services.

Questionnaire and key informant interview were used as the primary instrument of data collection. The sample size of the study was 110 respondents. Inferential statistical tools such as tables and percentages were used to analyze the data collected. The findings of the study indicated that women in Dutsin-Ma are aware of maternal healthcare services in their areas and they have adequately utilized it. The study therefore observed that, women in Dutsin-Ma have access to maternal healthcare services because they are cheaper and affordable.

The major challenges facing women and access to maternal healthcare services were financial constraints, ignorance, husband’s restriction, not listening to media sources and socio cultural beliefs of the people. The study therefore recommended that women should be educated and sensitized with their husbands, on the importance of maternal care and socio cultural disposition, also women should be empowered, maternal charges should be subsidized for all and finally government should bring maternal healthcare services to the door steps of women building of more maternal health centers and good road networks.


Chapter One


Introduction

1.1 Background to the Study

Health is central to community well-being, personal welfare and has strong influence on people’s earning capacity. It is fundamental to people’s ability to enjoy and appreciate all other aspects of life. Health care utilization is use of healthcare services by people. The healthcare utilization of a population is related to the availability, geographical access, quality, cost of services, perceived benefits, as well as to social-economic and cultural structure, and personal characteristics of the users.(Chakraborty et al., 2003; Onah et al., 2009).The joys of motherhood is childbearing, it is a source of sorrow to many households as many women lose their lives during child birth. Every single day, Nigeria loses about 2, 300 under five years old and 145 women of childbearing age (Federal Ministry of Health, 2005). Discussions on reproductive and sexual health rights which had hitherto been a ‘taboo’ in traditional African societies are on the increase according to African scholars (Aniekwu, 2006). While the right to health has been an internationally recognized human right, reproductive health rights gained formal acceptance only in 1993 and the need for women to have access to quality reproductive health services such as medical care, planned family, safe pregnancy, delivery care, treatment and prevention of sexually transmitted infections, such as HIV/AIDS is increasingly gaining recognition in Africa at large and Nigeria in particular (World Health Organization, 2004).
Despite this recognition, reproductive health of women is still one of the major health challenges worldwide particularly in resource-poor countries such as Nigeria. Women represent a vulnerable population group as a result of biological and gender-related differences. Reproductive ill-health accounts for 20% of the global burden of ill-health of women compared to 14% for men (World Health Organization, 2008).According to Shiffman (2007), the health status of countries has been assessed using women reproductive health indicators such as maternal mortality rates, antenatal care coverage, and proportion of delivery supervised by skilled birth attendants, unmet need for family planning among others. This clearly underscores the fact that, all efforts must be on deck by both government and non-governmental organization to ensure that women have access to reproductive health service. The International Conference on Population and Development (ICPD) and the Millennium Development Goals (MDGs), both set goals to reduce maternal mortality and improve access to reproductive health services. The MDG target number 5 to reduce maternal mortality by three-quarter and achieve universal access to reproductive health by the year 2015.(World Health Organization, 2004).

The current population of Nigeria is 189,689,126 people based on the latest United Nations estimate. Nigeria population is equivalent to 2.55% of the total world population (world population prospects, 2015). Abouttwo-third of the population live in rural areas, and most rural dwellers are involved in the agriculture sector. Ibrahim, M. K. (2005). In 2008, the adult literacy rate for both sexes was 74.8%. Nigeria has a high total fertility rate estimated at 5.5 births per woman (compared to a world average of 2.5). The fertility preference of Nigerian women is closely related to the number of living children. Despite the decline in childhood deaths, fertility rate has reduced partly due to the family planning prevalence rate and the high unmet need for contraception. (Babalola and Fatusi, 2009). According to latest WHO data published in 2015; the life expectancy at birth was estimated at 54.5 years (WHO, 2015). The health system in Nigeria is largely driven by the public sector (Okpani & Abimbola, 2015). The national government’s health expenditure per capita and budget allocation to reproductive health are low. The healthcare infrastructures and manpower are grossly inadequate, with most of the available healthcare resources located in urban areas. Healthcare financing is mainly through personal income or out-of -pocket payment (World Bank, 2015).
Health is inaccessible to majority of the population (UNICEF, 2012). Most people seeking healthcare services patronize traditional healers or unorthodox healthcare providers. Women in Nigeria face numerous reproductive health challenges such as an unacceptably high maternal mortality rate (MMR), high unmet need for contraception, infertility, human immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) epidemic and so on. Interestingly, wide disparity in women’s reproductive health exists between different geographical zones within Nigeria due to social, cultural, environmental and physical factors (Ladipo, 2008).

Until quite recently, reproductive and sexual rights were considered by most Africans as issues for discussion only by ‘queers’ and liberal feminist groups (Aniekwu, 2006). The typical traditional African values and societal norms view reproduction and sexual practices as very private issues not meant for public discussion. Thus, it was more or less a “sacrilege” to advocate for sexual rights, safe abortion and reproductive choice.

Cultural practices like female and genital mutilation (FGM) are accepted by many societies and the practice is not considered harmful or illegal by many. Many aspects of reproduction such as safe motherhood and family planning services were not regarded as ‘rights’ per se (Aniekwu, 2006). It is against this background that this study seeks to assess the reproductive health care services for women in Dustin- Ma local Government.


1.2 Statement of the Problem

High maternal morbidity and mortality rate is a huge public problem in the developing countries of the world, including Nigeria. The maternal mortality rate in Nigeria is 630 deaths per thousand live births and Nigeria ranks 10th position in the World record of health indicators (Criminal Investigation Agency World Fact book, 2012). With an estimated 52,000 annual deaths, Nigeria accounts for about 10% of all maternal deaths, globally and has the second highest mortality rate in the World, after India. It is also reported that, for every woman that dies from pregnancy-related causes, 20 to 30 more will develop short- and long-term damage to their reproductive organs resulting in disabilities such as obstetric fistula, pelvic inflammatory disease, a ruptured uterus, etc. ( World Health Organization (WHO), 2007; Shiffman and Okonofua, 2007).

Despite the existence of national programs for improving maternal and child health in Nigeria, maternal mortality and morbidity continue to be high and studies suggests that the majority of maternal deaths can be prevented or reduced if women have access to or visited maternal health services during pregnancy, childbirth and the first month after delivery (Dayaratna, 2000; World Health Organization, 2004; Federal Ministry of Health, 2005).

However, many women in developing countries do not have access to maternal healthcare services and it is reported that use of such services remain low in sub-Saharan Africa including Nigeria (Babalola and Fatusi, 2009); where only 58% of women have attended at least one maternal clinic during pregnancy, 39% of births are attended to by skilled professional, 35% of deliveries take place in a health facility and 43.7% receive postnatal care (World Health Organization, 2012). Darmstadt GL, Bhutta Z.A., Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal (2005) are of the opinion that accessibility of health services has been shown to be an important determinant of utilization of health services in developing countries. In most rural areas in Africa, one in three women lives more than five kilometers from the nearest health facility (World Bank2002). The scarcity of vehicles, especially in remote areas, and poor road conditions can make it extremely difficult for women to reach even relatively nearby facilities. Walking is the primary mode of transportation, even for women in labor (World Bank, 2002). Addai (2000) stated that women in higher socioeconomic groups tend to exhibit patterns of more frequent use of maternal health services than women in the lower socioeconomic groups, factors such as education appear to be important mediator.

This study therefore seeks to educate/enlighten women on the adequate importance of family planning services, prevention of sexually transmitted infections/HIV&AIDS, provide information and routine services for prenatal, postnatal, safe delivery, prevention of infertility and appropriate treatment, responsible parenthood against harmful practices and adequate counseling on women’s reproductive health. The study will assess the challenges and prospects of reproductive healthcare services for women in Dustin-ma Local Government Area of Katsina State.


1.3 Research Objectives

The main aim of this study is to assess the challenges(s) and prospects(s)of reproductive healthcare services for women in Dustin-ma local government area.

However Specific objectives of this study are:

  1. Ascertain the state of women reproductive services in Dustin-Ma local government area.
  2. Determine whether women have access to reproductive healthcare services in Dustin-Ma local government area.
  3. Identify the challenges facing women access to reproductive healthcare services in Dustin-Ma local area.
  4. Suggest ways that can be done to enhance women access to reproductive healthcare services in Dustin-Ma local government area.

1.4 Research Questions

General research questions are what are the challenges and prospects of reproductive healthcare services for women in Dustin-Ma local government area:

  1. What is the state and/availability of reproductive healthcare services for women in Dustin-Ma local government area?
  2. To what extent do women have access to reproductive healthcare services in Dustin-Ma local government area?
  3. What are the challenges faced by women in access to reproductive healthcare services in Dustin-Ma local government area?
  4. What are the ways that can be done to enhance women access to reproductive healthcare services in Dustin-Ma local government area?

1.5 Significance of the Study

The significance of this study is premise on the challenges and prospects of maternal healthcare services. This study will be significant theoretically and practically.

Theoretically, the study discovered that, there is limited literature on women and access to reproductive healthcare services. The study will therefore be significant because it will help to augment the existing body of literature on the topic.

Practically, the study will benefit individuals, government and international organization. For the individuals, the study will benefit them because at the end of the research, they will be able to understand the state of women reproductive health care services and also encourage women to take good care of their reproductive health needs.

The government will also benefit significantly from the study because the study will bring to limelight not only the state of women reproductive healthcare but also the challenges of reproductive healthcare services thereby making the government to see the urgent need to provide more reproductive healthcare services to improve maternal health in Katsina state. The international donor agencies and non- governmental organizations can also benefit from the study because most of the funding is done by them therefore, this work will enable these organizations channel their funds in the appropriate areas.


1.6 Scope and limitation of the Study

The scope of this study covers the challenges and prospects of reproductive healthcare services only for women living in Dustin-Ma local government area from the year 2014-2016.


1.7 Definition of Terms

Operational Definition of Terms

The following terms are defined operationally in the context in which they are used in this study.

Reproductive Health:

health is a process of complete fitness in issues relating to reproductive system of women both physically, socially and psychologically.

Reproductive Healthcare Services:

It is a complete state of fitness in women it could physically or psychological to issues of reproductive health functions and matters that includes the reproductive system of women that encompasses abortion information, education and communication about reproductive health, including normal and safe delivery and post-natal care, Human sexuality and responsible parenthood, and against harmful practices; adequate counseling; diagnosis and treatment for sexually transmitted diseases and other reproductive tract infections, as feasible; prevention of infertility and appropriate treatment. These are services that are given to women which enlightens women on the proper management of their systematic organs.

Woman:

A woman is any female of reproductive stage she could be married or not.


Chapter Five


Summary, Conclusion and Recommendations

5.1 Introduction

This study was intended to assess the reproductive healthcare services for women in Dutsin-ma local government area of Katsina State. specific objectives include to ascertain the state of women reproductive services in Dustin-Ma local government area, determine whether women have access to reproductive healthcare services in Dustin-Ma local government area, Identify the challenges facing women access to reproductive healthcare services in Dustin-Ma local area and Suggest ways that can be done to enhance women access to reproductive healthcare services in Dustin-Ma local government area. The chapter therefore, focuses on the summary, conclusion and recommendations to be put in place for effective accessing of reproductive healthcare services for women, to determine whether women have access to these services, analyze the problems associated with reproductive health; and suggest adaptable solution to the identified problems in the study area.


5.2 Summary

The chapter one of the studies focuses the background of the study was presented as on the introduction which contains the major objectives of the study. The objectives of the study include to ascertain the state of women reproductive healthcare services in Dustin-ma LGA, determine whether women have access to reproductive healthcare services in Dustin-ma LGA, identify the challenges facing women access to reproductive healthcare service in Dustin-ma LGA and to suggest ways that can be done to enhance women access to reproductive healthcare services in Dutsin-ma LGA.

In chapter two, relevant literature was reviewed to highlight what other authors have written about women and access to reproductive health services. The theoretical framework adopted by the researcher was the Andersen Health Behavioral Model to explain women access to reproductive health services.

In chapter three, studies was carried out in Dutsin-Ma local government area and a sample of 120 respondents was selected from a population 169, 829 using simple random and stratified sample technique. All research questions were asked to guide the study, data was collected using two-researcher developed and validated instrument mainly (a) questionnaires and (b) in-depth-interviews.

Chapter Four, Data collected from these instruments were analyzed both quantitatively and qualitatively using simple tables and percentages and discussion of findings, while chapter five focus on the summary, conclusion, recommendations and suggestion for further studies on the use of maternal healthcare services among women in Dutsin-Ma LGA.


5.3 Conclusion

Based on the information elicited from the primary and secondary sources of data, the study concludes as follows:

  1. The study found out that state and availability of maternal healthcare in Dutsin-Ma is moderate 70.9%.
    The respondents in the area are aware of the maternal healthcare services at their disposal. This therefore implies that, due to the fact that the population of the study is informed, most women in the area of study can access the services and this can consequently help to reduce maternal health problems within the area
  2. The study found out that women in Dutsin-ma have access 64.5% to maternal healthcare services in Dutsin-Ma local government area.
  3. The study observed that, women in the study area had access to maternal healthcare services. This is because most respondents agreed that they use less than 5kilometers to visit the nearest health center closer to them which still falls within the WHO specifications on distance to the hospital. Besides, most of the respondents either trek or use motorcycle to go to the hospital.
  4. The found out that husband’s (men) play a major role in health decision making 68.2% and payment of maternal health bills for their wives 78.2%.
  5. The study found out that majority of the women 41.8% in Dutsin-Ma local government don’t listen to media sources to get more information on the updates and important use of maternal health services.
  6. The observed that majority of respondent are not educated 39.1% which means most of the women are illiterates.
  7. The researcher discovered the major factors hindering women’s easier access to reproductive healthcare services include financial constraints 40.0%, unemployment among women, husband’s restrictions 6.4%, ignorance 28.2%, social cultural factors 11.8%and inadequate basic amenities 13.6%

5.4 Recommendations

Based on the conclusion drawn from the findings of this study, therefore seek to make the following short and long term recommendations;

  1. The level of illiteracy is very high amongst women, health workshops, seminars should be organized by the government at the local government and state level to enlighten and sensitize the women on health care utilization. Nongovernmental organizations (NGOs) which are concerned with health related issues also have vital roles to play in organizing seminars and workshops geared towards health care utilization.
  2. The government through the mass media (radio and television) should embark on an aggressive campaigns directed towards women’s place in health care access and utilization.
  3. The professional healthcare givers like nurses, doctors and traditional birth attendants should be sent on further care utilization and access for women within the axis of Dutsin-ma to ensure that every woman have access and utilizes maternal healthcare services.
  4. The government at the local, state and federal levels as a matter of urgency should create and improve road network within for easy access and utilization by women.
  5. The ministry of health in conjunction with other agencies should embark on the renovation of existing health care structures and also equipped them with modern and state arts of equipment for easy health care delivery.
  6. The study also recommends that district headquarters heads and religious heads should be involved in the dissemination of information to women concerning health care utilization and access found within their community.
  7. Lastly the study also recommends that there should be disposition of negative cultural values towards healthcare utilization of women in the community.

5.5 Suggestion for further Studies

The study has identified the necessity to investigate and analyze the nature of the cultural practices and how it affects the individual involve and the society at large especially the future generation.

More so, the study has identified the need to investigate the reasons why cultural practices with the prevalence of huge negative consequences on people is still seen as a normal way of life among women in Dutsin-Ma local government area of Katsina State.


Assessment Of Reproductive Healthcare Services For Women


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