Utilization Of Postnatal Care Services Among Mothers Attending Antenatal Clinic

Project and Seminar Material for Nursing (Science)

Abstract

This study focused on the utilization of postnatal care services among mothers attending antenatal clinic AMAC health center. The study is was specifically focused on determining social demographic characteristic of mothers attending antenatal clinic AMAC health center, determining the level of knowledge of women on postnatal care services, establishing cultural practices that affect utilization of postnatal care services by postpartum mothers and determining the attitude of nurses toward smothers attending postnatal care service offered at AMAC health center. The study adopted the survey research design and randomly enrolled participants in the study. A total of 50 responses were validated from the enrolled participants where all respondent are mothers attending antenatal clinic AMAC health center.

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

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background to the Study

Around the world, it is recognized that postnatal care is crucial in maintaining and promoting the health of the women and the newborn baby, while providing an opportunity for health professionals to identify, monitor and damage health conditions that may develop in the mother and newborn during the postnatal period. In addition, postnatal care provides health professionals with the opportunity to promote exclusive breastfeeding, personal hygiene, appropriate feeding practices and family planning counseling and services. Moreover, postnatal care allows for the provision of postnatal, postnatal care allows for the provision of postnatal vitamin A and Iron supplementation to the mother and immunization of newborns to provide them with optimal start to life. One of the factors that can enhance promotion of health for mothers and babies after their discharge from hospital, or at home is the utilization of postnatal care services. Postnatal care services are provided by hospitals, private and public health centre’s, clinics and private practioners (medical doctors and registered nurses and midwives) and offer a range of services for mothers and babies.

The management of postnatal care begins in the delivery room after delivery and extends throughout the postnatal period and should be directed to achieve the following objectives; Ensuring that postnatal care is related to the needs of the individual mother and baby, promotion of an environment that is conducive for interaction between health care providers and the mothers without fear and stress, Identifying potential problems in physical and or emotional well-bearing for mother and baby as early as possible and ensuring prompt and appropriate help and treatment, ensuring good communication between all the people providing care for the mother and baby and enabling parents to become confident in the necessary skills of caring for infant by providing opportunities for learning and discussion. There is a major gap in the continuum of care due to low coverage of post natal care (PNC).

Postnatal care (PNC) has a stronger element of hospital level care compared to antenatal care. PNC services may involve treatment of complications that might have occurred during the delivery and severe health conditions of the newborn, requiring skilled personnel and hospital facilities. The PNC services provided at community level include counseling on family planning, breastfeeding practices, nutrition, management of neo-natal hypothermia, early detection of postpartum complications and referral for such problems. The higher-level health care facilities are intended to provide these services as well as take care of post-delivery complications (J. Health PopulNutr 2009).
Newborn survival is inextricably linked to the health of the mother. Nowhere is this more evident than the high risk of death for newborns and infants whose mothers die in childbirth. (Geneva: UNFPA, 2005). For both newborns and mothers, the highest risk of death occurs at delivery, followed by the first hours and days after childbirth. The postnatal period (the time just after delivery and through the first six weeks of life) is especially critical for newborns and mothers. Given the exceptional extent to which the deaths of mothers and babies occur in the first days after birth, the early postnatal period is the ideal time to deliver interventions to improve the health and survival of both the newborn and the mother.

Four million infants die within their first month of life every year, representing nearly 40 percent of all deaths of children under age 5. (The Lancet365, no. 9462 (2005): 891-900) Almost all newborn deaths are in developing countries, with the highest number in South Asia and the highest rates in sub-Saharan Africa. Most newborn deaths occur at home, regardless of whether delivery was in the home or in a health care facility, and regardless of whether a skilled attendant was present at birth.

Statistics shows that a woman dies every 20 minutes in Pakistan due to maternal causes (Qureshi, Mirani and Hirani, 2006.) similarly, for every 1000 children born, 45 don’t live longer beyond first birthday (National Institute of Pakistan Studies, 2004). Pattern of under five child mortality shows that over half of deaths occur during neonatal period (i.e. first 28 days) and 26% occur during postnatal period and higher in rural areas (Pakistan Demographic Health Survey (PDHS) 2006-07). The highest risk of death for both the mother and newborn occurs at the time of childbirth or immediately in the period after delivery (Hunte, P. and F. Sultana, 1992).

In Africa, at least 125,000 women and 870,000 newborns die in the first week after birth every year, yet this is when coverage and programmes are at their lowest along the continuum of care. The first day is the time of highest risk for both mother and baby. The fact that 18 million women in Africa currently do not give birth in a health facility poses challenges for planning and implementing postnatal care (PNC) for women and their newborns. Regardless of place of birth, mothers and newborns spend most of the postnatal period (the first six weeks after birth) at home. Postnatal care (PNC) programmes are among the weakest of all reproductive and child health programmes in the region. (Opportunities for Africa’s newborn, section 3, chapter 4)

Despite the fact that around forty five percent of maternal deaths occur within the first 24 hours after childbirth, and over sixty five percent of maternal deaths occur during the first week of the postpartum period, (AED, The Manoff Group, USIAD 2005 Maternal Survival). Health care providers continue to advice on a first check up at 6 weeks after childbirth. This period is also critical to newborn survival, with between 50 to 70% of life threatening newborn illnesses occurring in the first week. Yet most strategies to reduce maternal and perinatal morbidity and mortality have focused on pregnancy and birth (comprehensive antenatal care and skilled attendance at birth). The heavy workload of providers who do not assess the mother post-delivery when she may bring her infant for immunization, lack of knowledge, poverty, cultural beliefs and practices perpetuate the problem.

The study also want to explore the factors influencing the utilization of postnatal care services by women, also, to examine the existing levels of utilization of postnatal care services, factors affecting the utilization of postnatal care services and drawing recommendations on the basis of the analysis of some data on utilization of post natal care services and finally to know if there exist any significance relationship between the factors associated with the utilization of postnatal care services among mothers.

1.2 Statement of the Problem

The postnatal period is neglected throughout Africa, as many women and their infants are not encouraged to seek care until six weeks after delivery, at which time they may or may not receive adequate attention. The FP needs of women during the first year postpartum are not well addressed in Nigeria, with 68 percent of women having an unmet need by 12 months. Pregnant and postpartum women need information and services, provided at appropriate times, to address this unmet need, including those mothers who are HIV-positive. Providing a continuity of care from antenatal services, including PMTCT, delivery, and postpartum care, can ensure that women’s health and fertility intentions are more likely to be effectively met. Health providers in Nigeria have traditionally focused on providing postpartum care and FP for the first time at the sixth week; only nine percent of postpartum women who gave birth at home received a postnatal care visit within two weeks of delivery (KDHS, 2003). There is clearly a need for providing information about the postnatal period not only during pregnancy, but also information and services at several points in time in the extended period postpartum.

1.3 Objectives of the Study

The main objective of the study is to determine the utilization of postnatal care services among mothers attending antenatal clinic. The specific objectives are;

To determine social demographic characteristic of mothers attending antenatal clinic AMAC health center..
To determine the level of knowledge of women on postnatal care services.
To establish cultural practices that affect utilization of postnatal care services by postpartum mothers.
To determine the attitude of nurses toward smothers attending postnatal care service offered at AMAC health center..

1.4 Research Question

What are social demographic characteristic of mothers attending antenatal clinic AMAC health center..
What is the level of knowledge of women on postnatal care services.
What are the cultural practices that affect utilization of postnatal care services by postpartum mothers.
What is the attitude of nurses toward smothers attending postnatal care service offered at AMAC health center.

1.5 Research Hypothesis

It is a statement that predicts the relationship between two or more variables. The hypothesis translates the research problem and the purpose into a clear explanation or prediction or prediction to the expectant results or outcome of the study (Burns and Grove, 1993). Below are some hypotheses in this study.

HO1: Mothers who have inadequate knowledge on postnatal care are not likely to attend postnatal care.
HO2: Some cultural practices influence mothers from attending postnatal clinics

1.6 Significance of the Study

The information that will be obtained from the study would be useful in making policies and to the stakeholders to come up with ways and means of improving postnatal care utilization among mothers attending antenatal clinic AMAC health center as a whole. Furthermore, the data collected will lay a foundation for further studies regarding to postnatal care utilization.

This study will create awareness on factors that influence utilization of postnatal care services thus solving the problem as well as bringing new knowledge.

1.7 Scope of the Study

The study will analyze the utilization of postnatal care services among mothers attending antenatal clinic amac health center. The study is limited to some selected mothers attending antenatal clinic AMAC health center. Hence, the respondents for this study will be obtained from and among mothers attending antenatal clinic AMAC health center.

1.8 Limitation 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 were able to manage these just to ensure the success of this study.

1.9 Definition of Terms

Mother:

A woman aged between 15-49 years of age and has delivered a child.

Postpartum Period:

Period from delivery up to six weeks during which the mother has to receive PNC.

Postnatal Care:

Is the care given to the mother and the infant from delivery up to six weeks.

Knowledge:

Refers to information needed and required by mothers in relation to postnatal care.

Attitude:

The way mothers feel and think about postnatal care. This could either be positive or negative.

Morbidity:

Refers to the occurrence of disease or illness among postpartum mothers and infants.

Mortality:

This is the death of women and infants during postnatal period.

Maternal Mortality:

This death of women as a result of child bearing commonly in the puerperal period.

Infant Mortality:

This is the number of infants under one month who die within the postnatal period.

1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusion and Recommendations

5.1 Introduction

This chapter summarizes the findings on the utilization of postnatal care services among mothers attending antenatal clinic AMAC health center. 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 utilization of postnatal care services among mothers attending antenatal clinic AMAC health center. The study is was specifically focused on determining social demographic characteristic of mothers attending antenatal clinic AMAC health center, determining the level of knowledge of women on postnatal care services, establishing cultural practices that affect utilization of postnatal care services by postpartum mothers and determining the attitude of nurses toward smothers attending postnatal care service offered at child welfare clinics in Akwa Ibom state.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 50 responses were validated from the enrolled participants where all respondent are mothers attending antenatal clinic AMAC health center.

5.3 Conclusion

The study sought to determine utilization of postnatal care services among mothers attending antenatal clinic AMAC health center. It was done from AMAC health center.. The sample size was 50 selected systematic using simple random sampling method. The results obtained in this study will contribute in the development of maternal and child health programmes.

The study revealed that so many factors influences PNC services utilization among them age of the mother, her education level, knowledge on PNC, occupation. Even though this study revealed all this, the inference made cannot be generalized due to small sample size of 50 mothers. Therefore there is need for the study to done on large scale in order to make a generalization of the entire population.

5.4 Recommendations

Based on the research finding, the researcher came up with the following:

There is need for health education to the community especially on PNC services by health workers on the benefits of seeking PNC services in the health care settings.
The community should be sensitized on the importance of mothers delivering in hospitals.
The community, Government, well-wishers and donors should initiate educational programmes with an aim of orienting the TBAs, Community Health Workers (CHW) on the importance of information, education and communication on Postnatal Care.
The community, the Government, well-wishers and donors should organize for outreach programmes, mobile clinics and construction of more clinics to cater for those residing far away from the clinic.
The ministry of health should also work with other sectors such as marriage institutions i.e. churches, NGOs and traditional institutions in creating awareness on PNC.