Constraints To The Utilization Of Antenatal Care Services Among Woman Of Reproduction Age (15-45) In Oko Health Center Community Oshimili North

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Constraints To The Utilization Of Antenatal Care Services Among Woman Of Reproduction Age (15-45) In Oko Health Center Community Oshimili North


Abstract


This study was carried out to examine the constraints to the utilization of antenatal care services among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North. The study was carried out to assess the level of awareness of the service provided by primary care center , assess the level of the untilization of the primary health care center available in the community, and determine the various constraints associated with the use of the primary health care center in the community. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of woman of reproduction age (15-45) in Oko Health Center Community Oshimili North. In determining the sample size, the researcher conveniently selected 147 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 there is poor level of awareness of the service provided by primary care center among women of reproductive age. In addition, the various constraints associated with the use of the primary health care center in the community include; maternal age, education, accessibility, occupation, and finance. 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
  • 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
  • 4.5 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background of the Study

Antenatal care is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and babies depend.1 Systematic antenatal care was first introduced early in the 20th century in Europe and North America and is now almost universal in the developed world.2
Antenatal care can be defined in various ways. WHO defines antenatal care as a dichotomous variable, having had one or more visits to a trained person during the pregnancy.3 It includes routine follow up provided to all pregnant women at primary care level from screening to intensive life support during pregnancy and up to delivery.4-6 The most common indicators of health and reproductive behavior include utilization rates of antenatal care, age when women give birth, pregnancy order and birth spacing. Health status is also influenced by distant factors; for example anemia can be due to lack of money to buy adequate and good quality food (SES) or to poor eating habits (health behavior). These factors can be modified if the services can be made accessible and affordable to women and their families.1,7

A number of studies have identified lack of antenatal care as a risk factor for maternal mortality.8-13 Certain other studies have observed an association between antenatal screening for poor obstetric history combined with proper referral, and lower risk for maternal death.11-15 Some of these studies have methodological weaknesses mostly related to not controlling for potential confounding factors, although, the effects were typically very pronounced, suggesting that an association is likely to exist. Several studies conducted in developing countries on demographic and socio-cultural factors influencing use of maternal health care services, have shown that factors like maternal age, number of living children, education, place of residence, occupation, religion and ethnicity are significantly associated with use of antenatal care.16-18 One of these studies have examined the relationship between antenatal care utilization and pregnancy outcome.16 Randomized controlled trials that assign women to different protocols have found little difference between intervention and control groups9,19, but these studies do not include populations of women with little or no antenatal care.

The present study was conducted to assess the constraints to the utilization of antenatal care services among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North.


1.2 Statement of the Problem

The trend of maternal mortality in developing countries has been increasing and various international organizations have reported that an important factor related to maternal and infant mortality has been linked to lack of antenatal care [Villar, et al. 2001]. According to Federal Ministry of Health [2005], some of the dangers of pregnancy and childbirth can be avoided if the pregnant woman attends antenatal regularly. In order to decrease these mortality rates, regular antenatal care has to be instituted or reinforced which can only be achieved through identifying factors causing poor utilization of antenatal care services.

According to WHO [2001] only 60% of women receive antenatal care in Nigeria, and not all of them attend the antenatal clinic regularly [Villar et al., 2001]. A study reported that with maternal risk held constant, low birth weight, and infant mortality were 1.5-5 times higher with late and less frequent antenatal care than with early and frequent care [Quick, Greenwick & Reghman, 1991]. A study carried out on reproductive health issues showed that in 69% of the recorded births, the mothers made 4 or more antenatal visits, while 20% made fewer than 4 visits and 6.3% did not attend at all which is contrary to WHO recommendation of 12 visits [Villar et al., 2001]. This shows that there are marked differential in the use of antenatal and same as been observed in Oshimili North. Thus giving rise to the need to identify the factors influencing the utilization of antenatal clinic among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North.


1.3 Objective of the Study

The main objective of this study is to examine the constraints to the utilization of antenatal care services among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North. Specifically the study intends to;

  1. To assess the level of awareness of the service provided by primary care center
  2. To assess the level of the untilization of the primary health care center available in the community
  3. To determine the various constraints associated with the use of the primary health care center in the community.

1.4 Research Questions

The following research questions will be answered in this study:

  1. What is the level of awareness of the service provided by primary care center among woman of reproduction age?
  2. What is the level of the untilization of the primary health care center available in the community by woman of reproduction age?
  3. What is the various constraints associated with the use of the primary health care center in the community?

1.5 Research Hypotheses

  • Ho: Woman of reproduction age does not have adequate awareness of antenatal care services
  • Ha: Woman of reproduction age have adequate awareness of antenatal care services.

1.6 Significance of the Study

This study will enable the health care professional to determine the factors causing poor or irregular utilization of antenatal care services and how to eradicate it. It will also help the government to develop and implement new policies towards encouraging proper utilization of antenatal care services, which will help to reduce maternal and neonatal morbidity and mortality rates.


1.7 Scope of the Study

This study is focused on the constraints to the utilization of antenatal care services among woman of reproduction age (15-45). The study will be delimited to pregnant women withing the age of 15 – 45years. Geographically, this study will be delimited to Oko Health Center Community Oshimili North.


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

Primary Health Care (PHC)

This is health care provided in the community for people making an initial approach to a medical practitioner or clinic for advice or treatment.

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.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the constraints to the utilization of antenatal care services among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was to examine the constraints to the utilization of antenatal care services among woman of reproduction age (15-45) in Oko Health Center Community Oshimili North. The study was specifically set to assess the level of awareness of the service provided by primary care center , assess the level of the untilization of the primary health care center available in the community, and determine the various constraints associated with the use of the primary health care center in the community.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondent are woman of reproduction age (15-45) in Oko Health Center Community Oshimili North.


5.3 Conclusions

In the light of the analysis carried out, the following conclusions were drawn.

  1. There is poor level of awareness of the service provided by primary care center among women of reproductive age.
  2. The level of the untilization of the primary health care center available in the community is high
  3. The various constraints associated with the use of the primary health care center in the community include; maternal age, education, accessibility, occupation, and finance.

5.4 Recommendation

From the findings of the study, the following recommendations are made:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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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