Perception Of Pregnant Women Towards Antenatal Care And Factors Militating Against It’s Utilization In Esan West LGA, Edo State, Nigeria

Project and Seminar Material for Nursing (Science)

Perception Of Pregnant Women Towards Antenatal Care And Factors Militating Against It’s Utilization In Esan West LGA, Edo State, Nigeria


Abstract


Utilization of antenatal care by pregnant mothers is important in improving maternal and neonatal health and survival. However, in Nigeria, although over 90% of mothers utilize the services, only 17% initiate it at the appropriate time. The study was conducted to assess the factors affecting the utilization of antenatal care services by pregnant mothers in Esan West Regional Referral Hospital.

A cross-sectional descriptive study design employing quantitative methods of data collection was used to collect data from 200 pregnant mothers who were selected using a simple random sampling method. Data was collected through the use of pretested questionnaire and is presented in tables, figures with frequencies and explanatory remarks.

According to the study findings the maternal related factors affecting the utilization of antenatal care services by pregnant mothers were age, marital status, educational level, whether the pregnancy was planned, knowledge of antenatal care and decision making power.

Regarding the socio-economic factors affecting the utilization of antenatal care services by pregnant mothers, number of dependents, partners support and educational level, occupation, and ability to afford transport costs were mentioned.

About the health related factors affecting the utilization of antenatal care services by pregnant mothers, waiting time, yelling and shouting at mothers, perceptions towards health workers, perceived quality of antenatal care and being advised by health workers to seek antenatal care.

In conclusion, the major factors found to be affecting utilization of antenatal care services were maternal age, educational level, partner support, occupation, waiting time and perceptions towards health workers.
Therefore, there is need for health workers to encourage male involvement in antenatal care while providing timely quality services to pregnant women in Esan West Regional Referral Hospital.


Chapter One


Introduction

1.1 Background of the Study

According to World Health Organization, (WHO, 2017), Antenatal Care (ANC) is the “care before birth”, and includes education, counseling, screening, and treatment to monitor and to promote the well-being of the mother and foetus. The aim of ANC is to assist women to remain healthy, to find and correct adverse conditions when present, and thus aid the health of the unborn.

Antenatal care deals with pre-symptomatic diagnosis of general medical disorders, nutrition, immunology, health education and social medicine in addition to prevention and early detection of pregnancy disorders. However many mothers have gone ahead to delay to go for booking (Medinda, 2014).

Early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and foetal outcome positively (Ndidi&Oseremen, 2010). However, poor ANC utilization is a global problem in both developing and developed countries (Tariq, Elford, Cortina &Tookey, 2012). UNICEF, (2011) reported that regional averages range from a low of 68% in South Asia to high of 95% in Central and Eastern Europe / Commonwealth of Independent States (CEE/CIS). In addition to CEE/CIS, more than 9 in 10 pregnant women attend at least once in Latin America, the Caribbean, East Asia and the Pacific. However, rates of late booking are rather higher for countries in Sub Saharan Africa (Baker & Rajasingam, 2012) due to lack of transport to health facilities and inadequate knowledge about when and why it is vital to book early for antenatal care.

Each year in Africa, 30 million women become pregnant, and about 250,000 of them die from pregnancy-related causes and in sub- Saharan Africa (Pearson, Larsson, Fauveau & Standley, 2009). Though timely ANC visit helps to improve maternal health outcomes, in sub-Saharan Africa the ANC utilization is low; the pregnant women who had at least one ANC visit are about 69%, and pregnant women who get ANC within 0-3 months of pregnancy are only 20%, which is low coverage compared to other parts of the world (Gomez &Munjanja, 2009).

In Nigeria, records from the Nigeria Demographic and Health Survey (UDHS, 2011) revealed that on average, only 17% of mothers initiated the first antenatal visit in the first trimester. The UDHS report further states that factors related to delayed booking included ‘low educational level belonging to poor economic status, inability to access media and poor obstetric history.


1.2 Problem Statement

Although all pregnant mothers are recommended to go for their first antenatal check-up in the first trimester or attend at least 4 ANC visits to identify and manage any medical complication as well as to screen them for any risk factors that may affect the progress and outcome of their pregnancy, (Rosliza& Muhamad, 2011) many women have poor antenatal care utilization. According to the Nigeria Demographics and Health Survey (UDHS, 2016), almost all women (97%) age 15-49 with a ‘live birth in the past 5 years received antenatal care (ANC) from a skilled provider during their most recent pregnancy. However, only 29% of women had their first ANC visit during the first trimester of pregnancy and only 60% completed at least four ANC visits.

Records obtained from Esan West Regional Referral Hospital (ERRH) showed that out of 55,430 women who accessed antenatal care in 2016, 46,006 (82.9%) accessed antenatal care after 3 months while only 24,389 (43.9%) completed 4 antenatal visits (Esan West regional referral hospital antenatal clinic records, 2018): This happened despite continuous health education by health workers to women of reproductive age about the importance of early booking, encouraging them to complete at least 4 visits, and motivating them through giving out maama kits. This predisposed the mothers to delayed detection of pregnancy related conditions like mal presentation, anaemia, infections like syphilis and gonorrhea among others. The researcher conducted a study about the factors affecting the utilization of antenatal care services by pregnant mothers in Esan West Regional Referral Hospital, Esan West Lga.


1.3 Purpose of the Study

To assess the factors militating against the utilization of antenatal care services and perception by pregnant mothers in Esan West Regional Referral Hospital, (ERRH) Esan West Lga so as to generate baseline data which will be used to improve maternal and child health through proper antenatal care utilization.


1.4 Specific Objectives

  1. To assess the related factors affecting utilization of ANC among pregnant mothers attending Antenatal care
  2. To identify the factors militating against utilization of ANC among pregnant mothers attending Antenatal care.
  3. To establish the perception of ANC among pregnant mothers attending Antenatal care

1.5 Research Questions

  1. What is the related factors affecting utilization of ANC among pregnant mothers attending Antenatal care?
  2. What is the factors militating against utilization of ANC among pregnant mothers attending Antenatal care?
  3. What is the perception of ANC among pregnant mothers attending Antenatal care?

1.6 Scope of the Study

The study focused on the different factors that affect perception of pregnant women towards antenatal care and factors militating against its utilization in Esan west LGA, Edo state, Nigeria


1.7 Justification of the Study

Provision of antenatal care is regarded’ as a cornerstone of maternal and perinatal health care and is expected to have a considerable impact on achieving Sustainable Development Goal (SDG 3) which seeks to ensure. healthy lives and promote well-being for all at all ages (Maternal Health Task Force (2018). WHO recommends a simplified antenatal care such that pregnant mothers attend at least 4 visits. However, only 64% of pregnant mothers attend 4 visits in Nigeria putting them at risk of maternal and neonatal conditions which could lead to morbidity and mortality (UDHS, 2016).

In Esan West Regional Referral Hospital, there were no ‘5tudies that had been carried out about the factors affecting utilization of ANC. The researcher carried out a study on the factors affecting utilization of ANC among pregnant mothers in ERRH in order to generate baseline data that may be used by health workers to formulate local policies aimed at increasing early booking by pregnant mothers.

This will help the Ministry of Health to draft policies and guidelines that lead to early and increased antenatal utilization nationwide.

The study will also act as a source of literature for future researchers who intend to carry out related studies. .


1.8 Definition of Key Terms

Antenatal Care:

The โ€œcare before birthโ€, and includes education, counselling, screening, and treatment to monitor and to promote the wellbeing of the mother and foetus.

Factors:

A circumstance, fact, or influence that contributes to a result.

Health Facility:

A hospital, health centre or clinic.

Maternal related:

Relating to a mother, especially during pregnancy or shortly after childbirth.


Chapter Five


Discussion, Conclusion and Recommendations

5.1 Conclusion

According to the study findings, the maternal related factors affecting the utilization of antenatal care services by pregnant mothers were age, marital status, education level, whether the pregnancy was planned, knowledge of antenatal care and decision making power.

Regarding the socio-economic factors affecting the utilization of antenatal care services by pregnant mothers, waiting time, yelling and shouting at mothers, perceptions towards health workers, perceived quality of antenatal care and being advised by health workers to seek antenatal care were identified as important.


5.2 Recommendations

  1. There is need for health workers to encourage men to get involved in antenatal care as a means of improving their knowledge about the practice and hence facilitate attitude change.
  2. There is need for the administration of Esan West Regional Referral Hospital through the Ministry of Health and Ministry of Public Services to recruit more health workers, especially those providing services to mothers and children.
  3. There is need for the administration of Esan West Regional Referral Hospital to caution health workers providing care to pregnant women to stop yelling and shouting at the mothers so as to foster a good client-health relationship.

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