Perception And Utilization Of Antenatal Care Among Pregnant Women Attending Selected Antenatal Clinics In Ede, Osun State
The main aim of this study was to assess the perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State. This is a descriptive study which targeted pregnant mothers attending antenatal care at the hospital. 100 respondents were selected using simple random sampling technique. The research instrument was a questionnaire which consisted of four parts that addressed the research questions and objectives. The data was analyzed using descriptive statistical method for the research questions and inferential statistics of chi-square for the hypothesis. Findings revealed that most of the respondents (82%) were satisfied with the overall quality of care rendered during their ANC service. Other findings showed that respondents access ANC services during pregnancy (70.2%), respondents obtain adequate care at the hospital for you ANC services (75.8%), respondents have adequate number of people attending to you during ANC service (67.5%), respondents like the attitudes of service provider towards pregnant women (65.1%), and respondents are always referred in case of health problem (52%). Also, test of hypothesis revealed that there is a significant relationship between the quality of care rendered and satisfaction with ANC services. The study concluded that it is necessary to address the financial reasons and other causes of dissatisfaction towards ANC services, and the quality improvement of ANC services to increase women’s satisfaction with ANC services. The study recommended that there is a need to review and strengthen reproductive health programs and ensure that they are friendly and are focused on the needs of the women and pregnant mothers.
Table of Content
- 1.1 Background of Study
- 1.2 Statement of Problem
- 1.3 Objectives of the study
- 1.4 Research Questions
- 1.5 Hypothesis
- 1.6 Significance of the Study
- 1.7 Scope of the Study
- 1.8 Limitation of the Study
- 1.9 Operational Definition of Terms
- 1.10 Organization of the Study
- 2.1 Conceptual Review
- 2.2 Antenatal Care
- 2.3 Theoretical Framework
- 2.3.1 The Theory of Assimilation
- 2.4 Empirical Review
- 3.1 Research Design
- 3.2 Target Population
- 3.3 Sample and Sampling Technique
- 3.4 Instrument for Data Collection
- 3.5 Validity of the Instrument
- 3.6 Reliability of the Instrument
- 3.7 Method of Data Collection
- 3.8 Method of Data Analysis
Results and Discussion
- 4.1 Results
- 4.2 Discussion of Findings
Summary, Conclusion and Recommendation
- 5.1 Summary of the Study
- 5.2 Conclusion
- 5.3 Recommendations
1.1 Background of Study
According to Bustreo, Say, Koblinsky and Pullum (2013) antenatal care is the care that a pregnant woman receives during her pregnancy through a series of consultations with trained health care workers such as midwives, nurses, and sometimes a doctor who specializes in pregnancy and birth (World Health Organization (WHO), 2015). These definitions focus on the mother’s satisfaction and the availability of best quality antenatal care service (Rheman, Ngadan & Arif, 2016). Mother’s level of satisfaction with the antenatal service given in the health facility is medically important and satisfied mothers had high adherence to the treatment given as well as they will be participants in the service and utilize the antenatal care service (Berhane, 2019). Antenatal care (ANC) is an important part of preventive medicine and professionals providing this service can reduce the risk of complications through education, counseling and various interventions. The proportion of Nigerian women that receive antenatal care and those that are delivered by skilled birth attendants has however remained far from acceptable (Nwaeze, Enabor & Aimakhu, 2013).
Lack of knowledge about the antenatal care services could be a major barrier to women’s utilization of ANC services. Due to lack of knowledge pregnant women are likely to have limited knowledge and experiences in seeking health care. Matua (2014) cited lack of adequate knowledge and information about pregnancy, laboratory tests results and dangers of late bookings or not attending ANC at all, as contributors to the poor utilization of ANC services. Lack of knowledge about the dangers of not seeking health care in pregnancy and delivery were major barriers to seeking health care among pregnant women in Uganda (Matua, 2014). It is evident from previous researches that, the knowledge about the antenatal care services, availability and accessibility of the services, the distance to the facility, the efficiency and skills of the staff/ workers hence quality of the services, costs incurred, that is the screening charges, transport costs, and the treatment costs, continuity and comprehensiveness of services, all play a part in influencing the utilization of antenatal care services. This however did not tell us to what extents these factors influence the utilization of ANC services. Furthermore, it is also affected by cultural beliefs, as well as personal characteristics of the user of these services. Sometimes the government policy too may affect ANC utilization.
For many years, high standards of care were considered a luxury particularly in developing countries where service coverage was largely inadequate. Quality of health care is seen as a factor closely related to effectiveness, compliance and continuity of care particularly for ethical reasons. Women’s perceptions of antenatal visits significantly influence their assessment of the quality of services that are provided (Nwaeze et al, 2013). As a result of this new focus, measurement of customer satisfaction has become equally important in assessing system performance. Patient satisfaction has traditionally been linked to the quality of services given and the extent to which specific needs are met. Satisfied patients are likely to come back for the services and recommend services to others (Nwaeze et al, 2013). Various factors including the attitude of staff, cost of care, time spent at the hospital and doctor communication have been found to influence patient satisfaction in previous studies (Nwaeze et al, 2013).
1.2 Statement of Problem
The assessment of antenatal care among women is the foundation of trust, intimacy, and respect to the nurses and midwives. Assessment should be therapeutic and focus on the maternal care. There is a demand to establish the assessment of maternal care among patients in every health institution, within hospitals as a tool to improve performance of antenatal care and services. Despite great efforts, health institutions and hospitals have a problem in implementing antenatal care assessment tools for patients.
During my clinical experience at Antenatal clinics, Ede, Osun State, I noticed that lack of assessment of antenatal care among pregnant mothers may have led to a lack of trust needed for a therapeutic management. As a result of this, there is no opportunity for the women to verbalize their opinions or suggestions because there is no room for it. This predisposes the women to develop mistrust and sometimes anxiety. This motivated me to assess the perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State.
1.3 Objectives of the study
The purpose of this study is to assess the perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State. The specific objectives of this study are outline as follows:
- To assess the perception ofpregnant mothers towards antenatal care service in Antenatal Clinics in Ede
- To identify the factors that affect utilizationof antenatal care among pregnant women attending selected antenatal clinics in Ede
- To ascertain the quality of care rendered during ANC to pregnant mothers attending Antenatal Clinics in Ede
1.4 Research Questions
The research questions are formulated based on the objectives and statement of problem to include;
- What is the perception of pregnant mothers towards antenatal care service in Antenatal Clinics in Ede?
- What are the factors that affect utilizationof antenatal care among pregnant women attending selected antenatal clinics in Ede?
- What is the quality of care rendered during ANC to pregnant mothers attending Antenatal Clinics in Ede?
The following hypothesis was formulated for this study;
- HO1: There is no significant relationship between perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State
- HA1: There is no significant relationship between perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State
1.6 Significance of the Study
The findings from this study are of significance to the pregnant mothers, the health sector and the society as a whole. Firstly, it will educate pregnant mothers on the benefits and effects of antenatal care services to their reproductive and overall health. Also, it will help to reduce maternal mortality and morbidity, and encourage the women to use the ANC services. The significance of an effective assessment of satisfaction with antenatal care among pregnant mothers is critical in maternal health maintenance and promotion. This study will help to identify maternal care gaps that can be used to improve antenatal care services rendered and improve women’s satisfaction and patronage. The study will also encourage the women to develop a positive attitude and confidence in nurses and midwives thereby promoting the image of the nursing profession. The study will also help to send feedbacks to service providers on how their patients see scare provided and their views regarding care provided. It is expected that the findings from this study will help stakeholders and health authorities to formulate policies and strategies in measures to improve the accessibility and quality of antenatal services among pregnant mothers. Finally, information gathered from this study will serve as a source of literature and guide for future research and as well serve as empirical reference for further studies.
1.7 Scope of the Study
The study covered pregnant mothers who sought consultation from November 2019 to January 2020 from the antenatal unit in Antenatal clinics, Ede, Osun State.
1.8 Limitation of the Study
In the course of this study, the researcher encountered some limitations. There was unwillingness of respondents to fill the questionnaires. Some of the copies questionnaires were also reported missing and it was severally replaced and this affected the researcher negatively finance wise. Also, the researcher faced time constraints and had to combine the research with other academic activities and coursework. Lastly, the researcher made use of Antenatal clinics in Ede, Osun state since all the health institutions in the state could not be exhausted.
1.9 Operational Definition of Terms
The way in which something is regarded, understood, or interpreted, in this case antenatal care.
This is the advice, supervision and attention given to a pregnant woman from the time of conception is confirmed until the beginning of labor.
The action of making practical and effective use of something, in this case antenatal care services.
1.10 Organization of the Study
This study is organized into five chapters. Chapter one included the background of the study, research problem, research objectives and questions as well as limitation of the study. Chapter two contains the literature review. Chapter three includes the methodology and study area. Chapter Four contains the results and discussion of key findings of the study. Chapter Five finally looks at the summary, conclusions, and recommendations based on the findings.
Summary, Conclusion and Recommendation
5.1 Summary of the Study
The primary objective of the study was to assess the perception and utilization of antenatal care among pregnant women attending selected antenatal clinics in Ede, Osun State. A descriptive survey research design and 100 respondents were used. A self-designed questionnaire was developed according to the objectives of the study to guide in the generation of information. Socio-demographic characteristics of the respondents and the research question were analyzed using simple frequency and percentage, while the hypothesis was analyzed using Chi-square analysis. From the findings, most of the respondents (82%) were satisfied with the overall quality of care rendered during their ANC service. Other findings showed that respondents access ANC services during all your pregnancy (70.2%), respondents obtain adequate care at the hospital for you ANC services (75.8%), respondents have adequate number of people attending to you during ANC service (67.5%), respondents like the attitudes of service provider towards pregnant women (65.1%), and respondents are always referred in case of health problem (52%). Also, there is a significant relationship between the quality of care rendered and satisfaction with ANC services since the ρ value (<.001) is less than the ∝ (0.05).
The study has shown overall satisfaction with the quality of care rendered during their ANC service among most of the pregnant mothers. Furthermore, the present study has shown that factors such as financial reasons, facility reasons and personal reasons are associated with dissatisfaction with ANC service among pregnant mothers. Long distance to health facilities, perception of quality of care rendered during the ANC services as well as individual choice of not wanting to make many visits also contributed to low satisfaction with ANC services among pregnant mothers in the study area. It is necessary to address the financial reasons and other causes of dissatisfaction towards ANC services, and the quality improvement of ANC services to increase women’s satisfaction and utilization of these services; these will ensure optimum contacts among women, society, and ANC providers in a bid to increase ANC coverage in the study area and in Nigeria s a whole.
The following recommendations were made based on the findings of the study;
- Firstly, the Ministry of Health and health regulatory bodies should review and strengthen reproductive health programs and ensure that they are friendly and are focused on the needs of the women and pregnant mothers. This should include continuous dissemination of information on antenatal care, delivery and postnatal care services to enhance accessibility by every pregnant woman.
- Secondly, there is need for social and emotional support by family and partners of pregnant women in a bid to encourage them to access the ANC services. This should also involve partnership between the authorities and community stakeholders increase health infrastructure so that distance to the health facility can be reduced.
- Lastly, information, education and communication strategies promoting health seeking behaviours should be enhanced both at the health facility and community level. This will provide adequate health information and ensure the execution of health literacy campaigns to improve health and pregnancy outcome amongst the women.
Perception And Utilization Of Antenatal Care Among Pregnant Women Attending Selected Antenatal Clinics In Ede, Osun State
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