Maternal health care seeking behaviour pregnancy outcome

Project Abstract

<p> The purpose of this study was to examine the maternal health care seeking behaviour and<br>pregnancy outcome of pregnant women in two rural communities in Enugu State. The<br>objectives of study were to (i) determine the gestational age at which pregnant women<br>book for Antenatal Care(ANC) in Udi and Abiacommunities, (ii)determine how often<br>pregnant women attend Antenatal Care(ANC)during the third trimester, (iii) ascertain the<br>facilities utilized by pregnant women with complications for care and (iv) ascertain their<br>pregnancy outcome. Cross-sectional survey design was adopted for the study. A sample<br>size of 207 respondents was drawn from a population of 586 pregnant<br>women. The instrument for data collection was the researcher-developed questionnaire<br>that was used as an interview guide. Observation guide was also used to corroborate the<br>findings of the questionnaire. The design of the study was descriptive cross-sectional<br>survey. Convenience sampling was used to select a sample size of 207 respondents from<br>a population of 586 pregnant women. Collected data wereanalysed using descriptive<br>statistics of frequencies and percentages. Chi-square was used to test for significant<br>association atsignificancelevel of 0.05.<br>Major findings show that most of the respondents (79.7%) booked for ANC during the<br>first trimester. On frequency of ANC during the third trimester, 81.1% maintained<br>weekly attendance while 100% of the respondents with complications accessed care from<br>health facilities especially the general hospital under skilled healthcare providers. On<br>pregnancy outcome, 84.5% of the babies cried vigorously at birth and 0.5% did not cry at<br>all. On maternal delivery outcome, 83.1% were strong to take care of self and baby after<br>delivery. There was no significant association (p &gt; 0.05) between the respondents’<br>demographic variables (age and educational status) and their healthcare seeking<br>behaviour. There was no significant association (p &gt; 0.05) between maternal healthcare<br>seeking behaviour and mothers’ delivery outcome (women that were strong to take care<br>of self and baby and those that were weak to take care of self and baby after delivery).<br>There was significant association (p &lt; 0.05) between maternal healthcare seeking<br>behaviour and babies’ birth outcome (number of babies that cried vigorously at birth and<br>those that did not cry at all). <br></p>

Project Overview

<p> INTRODUCTION<br>Background to the Study<br>A woman’s health care seeking behaviour during pregnancy depends a great deal on her<br>beliefs, culture, experience, educational level, financial status, attitude towards pregnancy,<br>as well as herautonomy and decision making power. Adele (2010)suggests issues of<br>importance to include information about pregnancy the woman’s family communicated to<br>her as a child and whether the pregnancy was planned or unplanned. Garba, Hellandendu,<br>andAjayi (2011) further explained that long before the advent of modern scientific<br>medicine, most cultures have among their patterns of life, a body of beliefs and practices<br>that centre on the recognition and treatment of complications of pregnancy and conduct of<br>deliveries. Thus, an understanding of appropriate health care seeking behaviour is very<br>important in achieving the desired pregnancy outcome. Negativebehaviour is highly<br>implicated in increased morbidity and mortality of mother and baby.<br>Osubor, Fatusi, and Chiwuzie(2006),suggests Maternal Health Care Seeking Behaviour<br>(MHCSB) to include the number of visits made to antenatal clinic (ANC) by pregnant<br>women and their preference for place of delivery.Jain, Nandan and Misra (2006) defined<br>health seeking behaviour as “a complex outcome of many factors operating at individual,<br>family and community levels including their biosocial profile, past experiences with health<br>services, availability of alternative health care providers, and the people’s perception<br>regarding the efficacy and quality of the services”.<br>Adele (2010) explains health seeking behaviour to be those activities undertaken by<br>individuals in response to any discomfort felt. He further stated that in the developed<br>countries like United States of America (USA), most women visit ANC early in<br>pregnancy, comply with prenatal directives and are attended to by skilled health care<br>providers when in labour. He also suggests that in the developing countries, especially in<br>the rural sub-Saharan Africa, most women consider pregnancy a natural process and the<br>services of skilled health care providers deemed not necessary. Rastogi (2012) observed<br>low utilization of ANC among rural women in India due to lack of means of<br>transportation, also because the women were often shy when discussing their health<br>problems before a male professional. Rastogi suggests that women who had formal<br>education up to secondary school level sought health care from skilled providers.<br>2<br>Jayaraman, Chandrasekhar and Gebreselassie (2008),stated that most of the pregnant<br>women deliver at home without skilled health care providers, while only a few receive up<br>to three antenatal visits.Woldemicael(2008) suggests that due to lack of transportation<br>some pregnant women may not utilize ANC and other delivery services by skilled care<br>providersin health facilities and therefore seek help from diverse fields.<br>Adamu (2011) suggests that MHCSB is the way mothers take care of their health and the<br>unborn child so that they will reach the end of pregnancy very healthy with positive<br>outcome.Yubia (2011) opined that in Nigeria, maternal health care seeking behaviour is<br>similar to that of other developing countries where negative health seekingbehaviours<br>shown by most mothers often lead to poor use of maternal health care services provided by<br>skilled health care attendants with eventual negative pregnancy outcome. Yubiafurther<br>explained that poor treatment seeking behaviours predispose them to complications that<br>could be properly managed if detected early during ANC. The number of women attending<br>ANC in southern Nigeriais higher than in the north.NDHS (2008) suggests that the<br>percentage of births attended to by skilled health care providers range from 81.8% in the<br>South East (SE) to9.8% in the North West (NW). Similarly, 90.1% of women in the NW<br>are more likely to give birth at home compared to 22.5% in the South West (SW).Adamu<br>(2011) suggests that this high attendance is associated with educational and economic<br>empowerment of more women in the southern than in the northern Nigeria. The number of<br>visits to ANC is a key determinant of whether a woman giving birth seeks institutional<br>care or care at home under a skilled health care provider as against delivery at home under<br>unskilled birth attendant.Adamu (2011)stated that a woman who attends ANC is more<br>likely to deliver in a health facility. Young mothers (below 35years) are also more likely to<br>make decisions on seeking health care than older mothers (above 35years) and to have<br>institutional delivery. On the other hand, older mothers especially multipara who have<br>never had any complications in pregnancy believe that safe delivery is a natural process so<br>may not seek health care under skilled health care providers. Yubia (2011) opined that<br>such women rely on their experience and help from fellow older mothers for care and<br>delivery.<br>Rastogi(2012) suggests that pregnant women do not develop much complicationif a skilled<br>health care provider regularly visits them at home.Babalola and Fatusi (2009) suggest that<br>3<br>the majority of maternal deaths and disabilities can be prevented through early and timely<br>access to and utilization of quality maternal health care services.WHO(2007) stated that<br>complications of pregnancy and childbirth are leading causes of maternal morbidities and<br>mortality for women of reproductive age (15 – 49 years) in developing countries. Nigeria<br>accounts for 10% of global maternal deaths and has the second highest mortality rates in<br>the world. It also reported that for every woman that dies from pregnancy – related causes,<br>20 – 30 more will develop short-and long-term damage to their reproductive organs<br>resulting in disabilities such as obstetric fistula, inflammatory diseases, and ruptured<br>uterus. In view of all these, this study examined the health care seeking behaviour of the<br>pregnant women in Udi and Abia communities and their pregnancy outcome. <br></p>