FACTORS AFFECTING CHOICE OF ANTENATAL AND DELIVERY CARE AMONG WOMEN OF CHILD BEARING AGE (15-49)

TABLE OF CONTENT

Title page

Approval page

Dedication

Acknowledgment

Abstract

Table of content

CHAPETR ONE

1.0   INTRODUCTION 

1.1        Background of the study

1.2        Statement of problem

1.3        Research questions

1.4        Objective of the study

1.5        Significance of the study

1.6        Scope of the study

1.7       Definition of terms

CHAPETR TWO

LITERATURE REVIEW

2.1 introduction

2.2 conceptual review

2.3 empirical review

CHAPETR THREE

3.0        Research methodology

3.1    sources of data collection

3.3        Population of the study

3.4        Sampling and sampling distribution

3.5        Validation of research instrument

3.6        Method of data analysis

CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS AND INTERPRETATION

4.1 Introductions

4.2 Data analysis

CHAPTER FIVE

5.1 Introduction

5.2 Summary

5.3 Conclusion

5.4 Recommendation

Appendix

Abstract

An antenatal care that seem to thrive on the understanding of the pregnancy state as a potentially dangerous biomedical state, and so goes on to have its mechanisms mainly on surveillance is proving ineffective in developing countries. Despite the many reasons given for poor utilization of ANC, especially in developing countries; The aim of the study was to investigate the supposed factors affecting the choice of antenatal and delivery care among women of childbearing age (15-49) in Okigwe. A purposive sampling of 300 expectant mothers from Okigwe district was selected by the researcher as a sample population of the study, the survey research method was adopted for the study and percentage method was used to analyzed the data obtained from the respondent with the aid of a structured questionnaire. It was discovered that husband’s decision or preference of ANC and privacy constituted the prominent factors that influenced the choice of ANC as well as place of delivery

CHAPTER ONE

INTRODUCTION

• Background of the study

Antenatal care (ANC) or high-quality prenatal care is an important aspect of the reproductive maternal, newborn and child health continuum of care. Continuum of care is an expression that captures the perceived enduring nature of care for the pregnant mother and child, even after birth. It recognizes that safe childbirth is critical to the health of both the woman and the newborn child and that a healthy start in life is an essential step to a sound childhood and a productive life (World health report 2010). The ANC provides the forum for women to be educated by health care providers about healthy pregnancy behaviors, danger signs of complications, breastfeeding and family planning; noticing and treating pregnancy-related pre-clampsia/ eclampsia; prompt referral to specialized care when needed; encourage the use of skilled birth attendants; and minimize the danger of mother – to – child transmission of viral diseases. As it were, ANC exists to ensure a veritable gateway to health services during and after maternity care moments. It ideally serves as an avenue of screening, identifying and treating other chronic conditions. It is a necessary opportunity to overall health of mother and child that, it is recommended for a positive pregnancy experience (WHO 2016). However, the still fluctuating increase maternal child mortality arising natal and neonatal cases; especially in sub-Saharan Africa, have become a pointer to the underuse or non-use of the opportunities ANC avails. Beyond the literatures about the reasons for its underutilizations, practical solutions that are people-concerned-oriented appear to be the leeway. Antenatal care (ANC) is the care 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 (FMOH 2012). An analytical review of the recent World Health Statistics showed that ANC coverage, between 2006 and 2013, was indirectly correlated with maternal mortality ratio (MMR) worldwide. This indicates that countries with low ANC coverage are the countries with very high MMR (Lincetto O Et al 2010). For instance, ANC coverage in United Arab Emirates was 100% with MMR of 8 per 100,000 and Ukraine had 99% ANC coverage and MMR of 23. By comparison, in subSaharan Africa, Ghana had ANC coverage of 96% and MMR of 380/100000, Chad had 43% ANC coverage and a MMR of 980/100,000, and Nigeria had ANC coverage of 61% and MMR of over 560. Nigeria’s MMR is clearly above the African and global average of 500 and 210 respectively (WHO 2014). The poor maternal health outcome in Nigeria could be a result of poor ANC utilization (Doctor HV Et al 2011) although ANC coverage may not provide information on the quality of care provided. The importance of ANC services in the outcomes for pregnant women has been well documented (Osungbade K, Et al 2008). ANC enhances early identification and management of conditions that could be threatening to the mother and her unborn child. ANC by trained skilled provider’s screens for infections, treats malaria, reduces the incidence of perinatal illness and death, provides birth preparedness, identifies signs of danger in pregnancy and plans to handle possible delivery complications through timely treatment and referrals (Lincetto O Et al 2010). It also reduces medical problems in pregnancy such as anaemia, hypertension, ectopic pregnancy, obstructed labour, eclampsia, excessive bleeding and premature labour and delivery (Osungbade K Et al 2011). In particular, a clinical audit of antenatal services in Nigeria found better maternal outcomes among women who had completed ANC than those who had not though it may not directly reduce the risk of death (Maine D 2001). Two nationally representative surveys were conducted recently in Nigeria: Nigeria Demographic and Health Survey (NDHS) in 2013 and National AIDS and Reproductive household survey (NARHS) in 2012. The two surveys showed that the proportion of pregnant women who had not attended any ANC services in Nigeria was 33.9% and 34.9% respectively. According to the 2013 NDHS, only 60.9% among women of child bearing age (15–49 years) who had a live birth in the five years preceding the survey received ANC from a trained skilled ANC provider (i.e., a doctor, nurse or midwife, or auxiliary nurse or midwife). Only half (51.0%) reported making four or more ANC visits during the pregnancy. About one third (36%) of births were delivered in a health facility while 38% of all deliveries within the five years were assisted by a skilled birth assistant (SBA) (National Population Commission 2013). The attendance of ANC and delivery in a facility by a trained birth assistant are far lower than most other Africa countries (WHO 2014, The World’s Women and Girls 2012). In Okigwe, the overall 75% had at least one ANC attendance, 48% had 4 or more ANC visits and 48% of deliveries were supported by skilled birth attendants.

• STATEMENT OF THE PROBLEM

Good care during pregnancy is important for the health of the mother and the development of the unborn baby. Pregnancy is a crucial time to promote healthy behaviours and parenting skills. Good ANC links the woman and her family with the formal health system, increases the chance of using a skilled attendant at birth and contributes to good health through the life cycle. Inadequate care during this time breaks a critical link in the continuum of care, and effects both women and babies. Antenatal care is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and babies depend. As a major interventional strategy to ensure that both the mother and child remain healthy especially in low resource areas, timely and prompt attendance to the clinic providing these services are essential. This is however, far from being the case. ANC attendance has regrettably been low. As such, across countries and territories, 1 in 4 pregnant women attends no ANC care, and more 43% have given births without institutional or skilled assistance. It is in view of the above that the study becomes pertinent to explore the factors affecting choice of antenatal and delivery care among women of child bearing age (15-49) in Okigwe.

• OBJECTIVE OF THE STUDY

The study has one main objective which is broken down into specific and general objective; the general objective is to examine the factors affecting choice of antenatal and delivery care among women of child bearing age (15-49) in Okigwe. The specific objectives are;

1. To ascertain if there are factors affecting antenatal and delivery care among women of child bearing age(15-49) in Okigwe
2. To ascertain if there is any significant relationship between the health of pregnant women who attend antenatal delivery care and those who do not

• To examine the awareness level of pregnant women on the need for antenatal and delivery care among women of child bearing age in Okigwe

1. To proffer suggested solution to the identified problem
   • RESEARCH QUESTIONS

The following research questions were formulated by the researcher to aid the completion of the study;

1. Are there factors affecting antenatal and delivery care among women of child bearing age (15-49) in Okigwe?
2. Is there any significant relationship between the health of pregnant women who attend antenatal delivery care and those who do not?

• Is there sufficient awareness programs for pregnant women on the need for antenatal and delivery care among women of child bearing age in Okigwe?
  • RESEARCH HYPOTHESES

The following research hypotheses were formulated by the researcher to aid the completion of the study;

H₀:  there are no factors affecting antenatal and delivery care among women of child bearing age (15-49) in Okigwe

H₁:  there are factors affecting antenatal and delivery care among women of child bearing age (15-49) in Okigwe

H₀:  there is no significant relationship between the health of pregnant women who attend antenatal delivery care and those who do not

H₂:  there is a significant relationship between the health of pregnant women who attend antenatal delivery care and those who do not

• SIGNIFICANCE OF THE STUDY

It is believed that at the completion of the study, the findings will be of great importance to women of child bearing in Okigwe and beyond as the study seek to examine the importance of antenatal and delivery care among women of child bearing age (15-49), the study will also be of great importance to researchers who intend to embark on a study in a similar topic as the findings of this study will serve as a pathfinder to further studies, the study will also be of importance to nurses and midwives who are saddle with the responsibility of educating women on the  benefits of antenatal and delivery care among women, the study will also be of great importance to researchers, academia’s, student, teachers and the general public as the study will contribute to the pool of existing literature on the subject matter and also contribute to knowledge.

• SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers the factors affecting choice of antenatal and delivery care among women of child bearing age (15-49) in Okigwe, but in the course of the study, there are some factors that limit the scope of the study;

AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study

TIME: The time frame allocated to the study does not enhance wider coverage as the researcher have to combine other academic activities and examinations with the study.

FINANCE: The finance available for the research work does not allow for wider coverage as resources are very limited as the researcher has other academic bills to cover.

 1.8 OPERATIONAL DEFINITION OF TERMS

Antenatal

Prenatal care, also known as antenatal care, is a type of preventive healthcare. Its goal is to provide regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy and to promote healthy lifestyles that benefit both mother and child

Child bearing

Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies leaves the uterus by passing through the vagina or by Caesarean section.

Women

A woman is a female human being. The word woman is usually reserved for an adult; girl is the usual term for a female child or adolescent.

1.9 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), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its 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.

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