KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN TOWARDS ANTENATAL CARE AND FACTORS MILITATING AGAINST ITS UTILIZATION IN ESAN WEST LOCAL GOVERNMENT AREA, EDO STATE, NIGERIA

CHAPTER ONE

INTRODUCTION

This chapter is discussed under the following headings:

• Background of Study
• Statement of problem
• Research Question
• Objectives of Study
• Significant of Study
• Scope of Study
• Limitation of Study
• Definition of terms

 Background of study

Antenatal care (ANC) has been a routine practice throughout the world since early in the 20th Century (Moos, 2006). It refers to pregnancy related health care provided by a doctor or a health worker in a health facility or home (Srilatha et al., 2002).

World Health Organization (WHO) and Wardlaw/United Nations International Children Emergency Fund (UNICEF, 2003) shows the percentage of various region such as in developed countries 98% of women have at least one antenatal visit, in developing countries the percentage drops to approximately 68%, in Nigerian the percentage falls to 58% while in Southeast Asia it has the lowest antenatal visit with 54% of women attending at least one antenatal visit.

Antenatal care-related expectations of pregnant women fall into four main categories: the wish to be provided with enough information, emotional support, general support in relation with representation of their interests, and the wish to be provided with professional care (Douglas et al., 2007).

Almost 90% of maternal deaths occur in developing countries while many women die because they do not receive the right medical care fast enough (Carroli, 2012). In most cases this is due to the fact that pregnant women, their families and the community in general, do not know about the danger symptoms and signs that can occur during pregnancy, labour or the puerperium. Four pillars of WHO Safe Motherhood Initiative include provision of Antenatal care facilities, clean and safe delivery, family planning and contraception and provision of emergency obstetric care.

Therefore the care that a woman receives during pregnancy helps to ensure healthy outcomes for women and newborns (WHO/UNICEF 2003). Antenatal care is a key entry point for a pregnant woman to receive a broad range of health promotion and preventive health services, including nutritional support,  prevention and treatment of anemia,  prevention, detection and treatment of malaria, tuberculosis and sexually transmitted infections (STIs)/HIV/AIDS (particularly prevention of HIV transmission from mother to child) and tetanus toxoid immunization. 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 newborns. It is also an ideal time to counsel women about the benefits of child spacing.

Finally, antenatal care is an essential link in the household-to-hospital care continum.  It is an intervention that can be provided at both the household and peripheral facility levels and helps assure the link to higher levels of care when needed.  In the developing world, nearly 70% of pregnant women have at least one antenatal care visit, and the majority of women presenting for any antenatal care have at least four visits (WHO/UNICEF 2003).

Statement of problem

Available evidence indicates that Nigeria has some of the worst statistics relating to maternal mortality in the developing world. Worldwide, an estimated half a million women die each year from complications of pregnancy and childbirth and of this, 55,000 maternal deaths occur in Nigeria alone (Nigerian Health Review (NHR), 2006). Thus, although Nigeria accounts for only 2% of the world’s population, it accounts for 10% of the global estimates of maternal deaths and this represents a major challenge to Nigeria. Maternal mortality is the highest in Africa with 1,100 mothers dying per 100,000 live births (WHO, 2006).  Nigerian Health Review (2006), reports that one of the major causes of maternal deaths is inadequate motherhood services such as antenatal care.

Antenatal care as the care given to pregnant women from conception to delivery has helped reduce maternal and child mortality. But it has become evident that antenatal care has been taken lightly during pregnancy noticed in  Esan West local government area as most pregnant women book for antenatal clinics at late pregnancy and go for antennal clinic just to obtain registration card in case of expected emergency and there may also be some factors hindering the utilization of ANC. This has resulted to too many complications during pregnancy, labour and delivery.

In view of this the researcher was motivated to find out the perception of pregnant women and factors militating against antenatal care in Esan West Local government Area, Edo state.

Objectives of study

1. To identify the knowledge and attitude of pregnant women towards antenatal care.
2. To identify the factors militating against antenatal care
3. To educate the pregnant women on the benefits and importance of antenatal care
4. To help promote the health of women and their infant during the period of pregnancy

Research Questions

1. What is the knowledge of pregnant women on antenatal care?
2. What is the attitude of pregnant women towards antenatal care?
3. What are the factors militating against antenatal care?

Significant of study

This study is important because it will bring awareness to rural areas about antenatal care, the hazards of late registration especially among primigravida and grand multigravida.

This will also help the community have a broader knowledge about antenatal care the usefulness and positive effects and help reduce maternal and fetal mortality during pregnancy.

Since ‘prevention is better than cure’ this study will help to reduce any health problem associated with pregnancy, make them live normally during the pregnancy period and having a life and healthy baby at the end.

Scope of study

This research study is carried out in Esan west local government Area of Edo State. Selected women in the Local Government Area were used. Esan West LGA is made up of 10 political wards located in 1.Ogwa  2.Ujiogba  3.Egoro and Ukhun, 4.Eguare and Emado 5. Ihumudumu, Idumebo, Ujemen and Uke  6. Iruekpen 7.Emuhi, Ujoelen and Ukpenu  8.Urohi  9. Uhiele  10. Illeh.  Out of the 10 wards 5 were selected in which 50 women were randomly selected and examined.

Limitations of study

During the course of study the researcher encountered the following problems:

1. Finance: The researcher been a student had challenges with money the little was spent judiciously.
2. Language barrier: The researcher does not understand their language so well, so collection of information was not easy because some women did not understand or speak English language.

• Time: The time scheduled for this work was short as other academic work went along side with this study.

 Definition of terms

1. Antenatal care: This the advice, care or supervision and attention given to a pregnant woman by a qualified health care professional from diagnosis of pregnancy to when delivery is accomplished.
2. Knowledge: The information, understanding and skills that one gains through education or experience.
3. Attitude: Acquired characteristics of an individual which predisposes him or her to respond in some preferential manner.
4. Pregnancy: This is the period from conception to birth.
5. Labour: This is the process by which the fetus, placenta and membranes are expelled through the birth canal.
6. Delivery: This is the natural expulsion of the fetus, placenta and membranes at birth.
7. Midwife: A woman who is specialized in helping pregnant women to have their babies.
8. Palpation: This is one of the assessment techniques health providers’ uses during physical examination t detect certain characteristics in the body.
9. Percussion: This a method of tapping body parts with fingers, hands or small instruments as part of a physical examination.
10. LMP: Last menstrual period.
11. EDD: Expected date of delivery.
12. Anaemia: Reduction in the number of hemoglobin count.

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