Factors Influencing Attitude Of Women Towards Antenatal Clinic In Madonna University Teaching Hospital, Elele

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Factors Influencing Attitude Of Women Towards Antenatal Clinic In Madonna University Teaching Hospital, Elele


Abstract


The broad objective of this study is to examine factors influencing attitude of women towards antenatal clinic in Madonna University Teaching Hospital, Elele. The research adopted the survey descriptive design and with the aid of convenience sampling method, the researcher conveniently selected two-hundred and sixty-four(264) participant Pregnant women and health care personnel working in midwifery department in Madonna University Teaching Hospital. Self- structured questionnaire was issued to the respondent of which sixty-two (262) were returned and two hundred and fifty-nine (259) were validated for the study. The study made use of of descriptive analysis and inferential statistics where data from field survey was analyzed using simple percentage, mean and standard deviation presented in frequencies and tables. Hypothesis test was conducted using ANOVA Statistical Package for the Social Sciences (SPSS v.23).Findings of the study reveals that the extent to which women visit antenatal care is on the average. This is because some of them are not aware of the medical implications and health risk associated thereof. Findings also reveal that those who are aware of the health and medical benefit of antenatal are either affected by social cultural factors, financial factors or healthcare facility related factors such as attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services.Based on the findings of this study, it is recommended that to improve the knowledge and attitudes of pregnant women regarding ANC, materials such as pamphlets or brochures and other forms of media (television, radio) should be made available to pregnant women to enhance their knowledge and raise awareness about the importance of ANC services; health education regarding ANC services must be given to women every day in the waiting areas of healthcare facilities, thus, the healthcare 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; workshops and training should be conducted for healthcare workers to improve those observed weaknesses which were barriers to the utilisation of ANC services; and that traditional practitioners should be involved in maternal healthcare programmes so that they can be equipped with information to improve their skills needed for maternal care.


Table of Content


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 Organization 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 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 2018). 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, 2017).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, 2016). 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, 2018). 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., 2017). 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 effect of ANC among women of Ago-Iwoye.


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, forevery 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).

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, 2019). 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. Upon this premise this study, the study therefore seeks to assess factors influencing attitude of women towards antenatal clinic in Madonna University Teaching Hospital, Elele.


1.3 Objective of the Study

The broad objective of this study is to assess factors influencing attitude of women towards antenatal clinic in Madonna University Teaching Hospital, Elele.

Other specific objective includes:

  1. To examine the extent to which pregnant women in Elele utilize antenatal services during pregnancy
  2. To identify pregnant women’s knowledge about antenatal care utilization in Elele.
  3. To assess pregnant women’s attitude towards the use of antenatal care in Elele.
  4. To determine the demographic, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant women on antenatal care utilization in Elele.

1.4 Research Questions

  1. What is the extent to which pregnant women in Elele utilize antenatal services during pregnancy?
  2. What are pregnant women’s knowledge about antenatal care utilization in Elele?
  3. What are pregnant women’s attitude towards the use of antenatal care in Elele?
  4. What are the factors that may contribute to the associated knowledge and attitude of pregnant women on antenatal care utilization in Elele?

1.5 Research Hypothesis

Ho1: There are no significant factors affecting attitude of pregnant women on antenatal care utilization in Elele.

Hi1: There are significant factors affecting attitude of pregnant women on antenatal care utilization in Elele.


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 Ago-Iwoye, 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 studyis intended to extract the knowledge and attitude of pregnant women on the benefits of ANC utilization during antenatal visits. The findings of this study in Elele 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

The scope of this study borders on factors influencing attitude of women towards antenatal clinic in Madonna University Teaching Hospital, Elele. The study further discuss pregnant women’s knowledge about antenatal care utilization and financial, healthcare facility, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant women on antenatal care utilization. The study is delimited to pregnant women in Elele.


1.8 Limitation of the Study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scantiness of literature related to factors influencing attitude of women towards antenatal clinic. Thus much time and organization was spent by the researcher in sourcing for the relevant materials related to the study. More so, the study is limited in scope focusing in Madonna University Teaching Hospital, Elele. Therefore findings of this study cannot be used for generalization for other healthcare facilities which creates a research gap and give room for further studies on this topic.


1.9 Definition of Terms

Ante-natal:

The provision of special care for women during pregnancy to facilitate safe and easy delivery.

Post-natal:

The provision of special care of women after women after delivery to monitor the baby’s health.

Obstetrics:

From the Latin word obstare, “to stand by” is the surgical specialty dealing with the care of women and her offspring during pregnancy, children and the pureperium (the period shortly after birth) most obstetricians are also gynecologist.

Ante-natal Depression:

Is depression that some women feel while they are pregnant.

Embryo:

Concepts between times of fertilization to 10 weeks of gestation.

Foetus:

From 10 weeks of gestation to time of birth

Infant:

Time of birth to 1 year of age

Gestational Age:

Time from last menstrual period (LMP) up to present

First Trimester:

Up to 14 weeks of gestation

Second Trimester:

14 to 28 weeks of gestation

Third Trimester:

2 weeks to delivery.


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, Conclusion and Recommendation

5.1 Summary

The broad objective of this study is to examine factors influencing attitude of women towards antenatal clinic in Madonna University Teaching Hospital, Elele. The study further discuss pregnant women’s knowledge about antenatal care utilization and financial, healthcare facility, social and cultural factors that may contribute to the associated knowledge and attitude of pregnant women on antenatal care utilization.

This research is reported in five distinct yet interrelated chapters. In the chapter one we describes the study objectives clearly by stating the motive behind this study. Research hypotheses were developed for testing while the scope of this research was defined as well.

The research adopted the survey descriptive design and with the aid of convenience sampling method, the researcher conveniently selected two-hundred and sixty-four(264) participant Pregnant women and health care personnel working in midwifery department in Madonna University Teaching Hospital. Self- structured questionnaire was issued to the respondent of which sixty-two (262) were returned and two hundred and fifty-nine (259) were validated for the study. The study made use of of descriptive analysis and inferential statistics where data from field survey was analyzed using simple percentage, mean and standard deviation presented in frequencies and tables. Hypothesis test was conducted using ANOVA Statistical Package for the Social Sciences (SPSS v.23).


5.2 Conclusion

Understanding maternal knowledge and practices of the community regarding care during pregnancy and delivery is very necessary and important. The utilization of antenatal care from a trained provider is important to monitor the pregnancy and to reduce morbidity and mortality risks for the mother and child during pregnancy and delivery. Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women’s experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care.

Findings of the study reveals that the extent to which women visit antenatal care is on the average. This is because some of them are not aware of the medical implications and health risk associated thereof. Findings also reveal that those who are aware of the health and medical benefit of antenatal are either affected by social cultural factors, financial factors or healthcare facility related factors such as attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services.


5.2 Recommendations

Based on the findings of this study, it is recommended that to improve the knowledge and attitudes of pregnant women regarding ANC, materials such as pamphlets or brochures and other forms of media (television, radio) should be made available to pregnant women to enhance their knowledge and raise awareness about the importance of ANC services; health education regarding ANC services must be given to women every day in the waiting areas of healthcare facilities, thus, the healthcare 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; workshops and training should be conducted for healthcare workers to improve those observed weaknesses which were barriers to the utilisation of ANC services; and that traditional practitioners should be involved in maternal healthcare programmes so that they can be equipped with information to improve their skills needed for maternal care.

It is recommended that health education programs should be undertaken by communities to improve women’s awareness of ANC and that the Ministry of Health should provide ANC services such as mobile health care and home care visits for remote villages or those difficult to reach. At the same time, ANC services should be affordable, especially for poor pregnant women.


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