Attitude Of Pregnant Mothers Towards Antenatal Care Services (15-59 Years)
This study was carried out to examine the attitude of pregnant mothers between 15-59years towards antenatal care services in Nsukka, Enugu State. The study was carried out to identify pregnant mothers knowledge about antenatal care services; assess pregnant mothers attitude towards the use of antenatal care services; and determine the demographic, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant mothers towards antenatal care services. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of pregnant mothers between 15-59years in Nsukka, Enugu State. In determining the sample size, the researcher conveniently selected 89 respondents and all were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that the majority of the participating women know the importance of ANC services although education level affected its utilization. Furthermore,the study also revealed that the main factors influencing the utilization of ANC are the respondent’s level of education, knowledge, and attitude. In addition, low income, long-distance, insufficient or expensive transportation services are major obstacles to ANC access for pregnant women. Therefore, it is recommended that health-care workers must ensure the privacy of pregnant women during procedures and must maintain confidentiality concerning their health information. As bridge of privacy in facilities caused women to have negative attitudes towards the ANC services. To mention but a few.
Table of Content
- Title Page
- Table of Content
- List of Tables
- 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
Review of Literature
- 2.1 Conceptual Framework
- 2.2 Theoretical Framework
- 2.3 Empirical Review
- 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
Data Presentation and Analysis
- 4.1 Data Presentation
- 4.2 Analysis of Data
- 4.3 Answering Research Questions
- 4.4 Test of Hypotheses
- 4.5 Discussion of Findings
Summary, Conclusion and Recommendation
- 5.1 Summary
- 5.2 Conclusion
- 5.3 Recommendation
1.1 Background of the Study
Antenatal Care (ANC) is given different meanings by different scholars, among others the meaning that says, “Antenatal Care means care before birth and includes education, counselling, screening and treatment to monitor and to promote the well-being of the mother and fetus” (Adewoye et al., 2013). Antenatal Care is an opportunity to promote the benefits of skilled attendance at birth and to encourage women to seek postpartum care for themselves and their newborn. It is also an ideal time to counsel women about the benefits of child spacing (Ye, Harun-Or-Rashid & Junichi Sakamoto, 2010).
According to the United Nations Millennium Development Goals, every year, at least half a million women and girls die as a result of complications during pregnancy, childbirth or the six weeks following delivery. Almost all (99%) of these deaths occur in developing countries. This shows that the Antenatal care activity is very weak in developing countries. The main reasons that hinder the use of antenatal care are different from country to country. Developing countries encounter hemorrhage, followed by eclampsia, infection, abortion complications and obstructed labor. Other issues are lack of knowledge and preparedness about reproductive health in the family, community and health provider (Ojo, 2014).
To alleviate such factors, Antenatal Care is the most important method for detecting pregnancy problems in the early period. Because antenatal care is the best mechanism to minimize maternal mortality and give a piece of good information for pregnant women about their birth and how to prevent related problems. The best and most advantage of Antenatal Care is to protect the health of women’s and their infants as well as indicating the danger signals that will be occurred and needs to be further treated by advanced health professionals (Effendi, Isaranurug & Chompikul, 2008). Several studies indicate that the Antenatal Care utilization rate is still low due to many factors that need to be examined such as sociodemographic factors, knowledge of social support. They conclude that eliminating such factors is important to increase women’s participation in Antenatal Care. In Ethiopia, although, access to health care services is improving, the country has faced challenges in increasing health care utilization and the proportion of women who give birth with the assistance of skilled attendants is the lowest in Sub-Saharan Africa (Regassa, 2011).
Proper ANC is one of the important ways in reducing maternal and child morbidity and mortality. Unfortunately, many women in developing countries do not receive such care (Ye et al., 2010). Understanding maternal knowledge and practices of the community regarding care during pregnancy and delivery are very necessary and important. Since data on this very important issue are scarce in some communities, therefore, this study was carried out to evaluate the attitude of pregnant mothers towards antenatal care services.
1.2 Statement of the Problem
Every minute, at least one woman dies from complications related to pregnancy or childbirth that means 529,000 women a year. In addition, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease approximately 10 million women each year. Studies reveal that the cause of maternal mortality in developing countries is mostly due to poor accessibility to maternal health services poor referral to appropriate antenatal and delivery care units, and inadequacies of available care. These studies suggested that most of the maternal deaths were preventable with improved coverage of antenatal care, safe delivery and postpartum care. There are regional variations in antenatal care utilization rate basically due to differences in the availability of health care facilities, among the regions during 1985–1990, the antenatal coverage rate for the whole of Africa was 60% compared to 99% for developed countries (Ethiopia Demographic and Health Survey, EDHS, 2016).
Based on EDHS 2016 report, in Ethiopia, the maternal mortality rate has been estimated to be 676 per 100,000 live births. This is one of the highest rates in the World. In addition, women’s reproductive health problems are a timely and serious matter of concern, for any health professionals, the government as well as society. Antenatal care related problem parameters are very sensitive because it is directly related with maternal morbidity and mortality, and loss of the fetus. It is a necessary component of maternal health to identify complications. According to the 2011 Ethiopia Demographic and Health Survey (DHS), antenatal care coverage of Ethiopia was 43%. Regular Antenatal Care visits can provide some benefits for the women such as a care provider that can result in reducing complications during pregnancy the absence of this activity affects millions of mothers in the rural as well as urban areas. The Nigerian Demographic and Health Survey (NDHS) in 2013, however, stipulated that approximately 576 women per 100,000 live births die as a result of pregnancy and childbirth-related complications. In the same vein, in a study conducted by Fagbamigbe and Idemudia (2015), findings revealed that affordability, availability, and accessibility of ANC providers are the most common problems facing utilization of ANC in Nigeria. Government-owned health institutions in Nigeria are not being effective in encouraging women to attend antenatal care (Nwosu, Urama & Chigozie, 2012).
Many women from different studies have mentioned that women are embarrassed when visiting an ANC. With improved knowledge about the benefits of ANC and the importance of a positive attitude toward it, these women will come to understand that ANC’s medical procedures and interventions will do much to save their lives and improve their children’s health. In this way, they will be motivated enough to overcome their reluctance. In many ways, changing attitudes and behavior are the most challenging tasks, but are also the least costly. Proper educational campaigns and the improved dissemination of information are investments for the long-term (Igbokwe, 2012). Most previous studies done on knowledge and attitude of women toward ANC were community-based done on general women of child-bearing age. Until now little has been known about the knowledge and attitude of women who are currently using ANC services. Therefore, this study will help to the percentage of women who benefit from this very important service of women’s health and have a good attitude about antenatal care services. This study examines attitude of pregnant mothers towards antenatal care services.
1.3 Objectives of the Study
The main objective of this study is to examine the attitude of pregnant mothers between 15-59years towards antenatal care services.
Other objectives of this study are:
- Identify pregnant mothers knowledge about antenatal care services.
- Assess pregnant mothers attitude towards the use of antenatal care services.
- Determine the demographic, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant mothers towards antenatal care services.
1.4 Research Questions
The following research questions will be answered in this study:
- What is the knowledge of pregnant mothers about antenatal care services?
- What is attitude of pregnant mothers towards the use of antenatal care services?
- What are the demographic, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant mothers towards antenatal care services?
1.5 Research Hypotheses
- Ho: Pregnant mothers does not have positive attitude towards antenatal care services
- Ha: Pregnant mothers has positive attitude towards antenatal care services
1.6 Significance of the Study
This study is significant and worthy of investigation to provide corresponding research into the impact of antenatal care on pregnant women in Nigeria.
The significance of this study will be helpful to pregnant women in various endeavors in an integrated and enthusiastic approach in tackling problems and challenges inherent in the conception period. However, it will contribute to academic knowledge in availing researchers to have a broad insight into the consequences of having sound antenatal care. However, the significance of this research study will also be a source of empirical framework for future researchers into this concept.
This study is intended to extract the knowledge and attitude of pregnant women on the benefits of ANC utilization during antenatal visits. The findings of this study will serve as a reference for giving intervention accordingly by the health care providers and others who are concerned; for conducting further researches; the findings of this study will have special importance for health care providers because it will serve as a baseline for filling gaps of the actual practices on antenatal care. The findings with relevant recommendations will be also submitted to the health care centers involved in the study for the implementation of the researchers’ recommendation.
1.7 Scope of the Study
This study is focused on the attitude of pregnant mothers towards antenatal care services in Nigeria. The study will be delimited to pregnant women withing the age of 15 – 59years. Geographically, this study will be delimited to pregnant mothers in Nsukka, Enugu State.
1.8 Limitations 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 was able to manage these just to ensure the success of this study.
Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.
1.9 Definition of Terms
Antenatal Care Services
ANC is a key element of the package of services aimed at improving maternal and newborn health.
1.10 Organization of the Studies
The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.
Summary, Conclusions and Recommendations:
This chapter summarizes the findings on the attitude of pregnant mothers between 15-59years towards antenatal care services in Nsukka, Enugu State. 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 attitude of pregnant mothers between 15-59years towards antenatal care services in Nsukka, Enugu State. The study was specifically carried out to identify pregnant mothers knowledge about antenatal care services; assess pregnant mothers attitude towards the use of antenatal care services; and determine the demographic, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant mothers towards antenatal care services.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 89 responses were validated from the enrolled participants where all respondent were pregnant mothers between 15-59years in Nsukka, Enugu State.
The results of this study confirmed that the utilization rate of ANC services was high in Nsukka, Enugu State, Nigeria. The main factors influencing the utilization of ANC are the respondent’s level of education, knowledge, and attitude. In addition, low income, long-distance, insufficient or expensive transportation services are major obstacles to ANC access for pregnant women.
From the findings of the study, the following recommendations are made:
- Health-care workers must ensure the privacy of pregnant women during procedures and must maintain confidentiality concerning their health information. As bridge of privacy in facilities caused women to have negative attitudes towards the ANC services.
- Programmes must be developed to directly improve the knowledge of pregnant women and communities by addressing the challenges that women encounter when they access ANC services.
- Health education regarding ANC services must be given to women every day in the waiting areas of health-care facilities. The health-care workers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions so that they can identify the level of the women’s knowledge.
- Health-care policy makers should also focus on meeting the health information needs of women and enable them to become well-informed and knowledgeable to make informed maternal health decisions.
- Workshops and training should be conducted for health-care workers to improve those observed weaknesses which were barriers to the utilisation of ANC services. Traditional practitioners should be involved in maternal health-care programmes so that they can be equipped with information to improve their skills needed for maternal care.
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