ABSTRACT

Antenatal Care (ANC) is an essential component of maternal healthcare that promotes the health and wellbeing of pregnant women and their unborn children through health education, early detection of complications, disease prevention, and appropriate management during pregnancy. Despite the proven benefits of ANC, maternal and neonatal morbidity and mortality remain high in many developing countries, including Cameroon. Poor knowledge of ANC and several socio-economic and health system barriers continue to limit the utilisation of ANC services among pregnant women.

The study was conducted to assess the knowledge and use of antenatal care services among pregnant women in the Mutengene Community. Specifically, the study sought to assess the level of knowledge pregnant women have on ANC services and identify the factors hindering pregnant women from attending ANC services. A community-based descriptive cross-sectional study design was adopted. The study was carried out among 110 pregnant women residing in the Mutengene Community, selected using a purposive sampling technique. Data were collected using a structured questionnaire and analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics such as frequencies and percentages were used to present the findings.

The results revealed that the majority of respondents (93.6%) had heard of ANC, while 68.2% correctly defined ANC as care provided to a pregnant woman and her unborn child before labour. Most respondents (60.9%) knew that a pregnant woman should attend ANC at least eight times during pregnancy, while 83.6% correctly identified the purpose of ANC as monitoring the health of both the mother and baby. Furthermore, 85.5% agreed that ANC helps in the early detection of pregnancy complications, and 87.3% believed that regular ANC attendance improves maternal and foetal health.

The study also found that distance to health facilities (71.8%), transportation costs (71.8%), long waiting times (74.6%), healthcare workers’ attitudes (70.9%), and the cost of ANC services (68.2%) were major barriers to ANC attendance. Conversely, partner support (80.9%), family encouragement (79.1%), adequate knowledge of ANC (80.9%), and health education (85.4%) positively influenced ANC utilisation. The study concluded that pregnant women in the Mutengene Community possess a generally good level of knowledge regarding ANC services. However, ANC attendance is still hindered by financial, geographical, and health service-related challenges. Addressing these barriers is essential for improving ANC utilisation and maternal health outcomes.

The study recommends strengthening health education programmes on ANC, improving access to maternal healthcare facilities, reducing waiting times in ANC clinics, promoting community sensitisation activities, encouraging male partner involvement in maternal healthcare, and implementing measures to reduce the financial burden associated with ANC attendance.

Keywords: Antenatal Care, Knowledge, ANC Utilisation, Pregnant Women, Maternal Health, Factors Influencing ANC Attendance, Mutengene Community, Cameroon.

 

CHAPTER ONE

INTRODUCTION

1.1. Background

Antenatal Care (AN) can be defined as care before birth and includes education, counseling, screening and treatment to monitor and to promote the well – being of the mother and fetus (Adewoye et al., 2019). In short it is the care that a woman receives during pregnancy that helps to ensure healthy outcomes for women and newborn (Adewoye et al., 2019).It is a key entry point for pregnant women to receive a multiple range of health services such as nutritional support and prevention or treatment of anemia; prevention, detection and treatment of malaria, tuberculosis and sexually transmitted infections (Kalayou et al., 2014).

The importance of Antenatal Care cannot be under rated as it is an opportunity to promote the benefits of skilled attendance at birth and encourage women to seek postpartum care for themselves and their newborn.

It is also an ideal time to counsel women about the benefits of child spacing (yang et al., 2010). Antenatal Care act as a key entry-point for implementing nutrition and health educational interventions that promote preventive health behaviors to improve maternal and neonatal health through better knowledge, attitudes and practices (Ochako et al., 2011). According to the United Nations Sustainable Development Goals, every year, at least half a million women and girls die as a result of complications during pregnancy, childbirth or the six weeks following delivery. Almost all (99%) of these deaths occur in developing countries. Approximately 810 women die every day from preventable causes related to pregnancy and childbirth around the world. Global maternal deaths estimated about 295,000 women died during and following pregnancy and childbirth. The vast majority of these deaths (94%) occurred in low-resource settings, and most could have been prevented. The Sub-Saharan Africa region alone accounted for roughly two-thirds (196,000) of maternal deaths (Simkhada et al., 2008). This shows that the Antenatal care activity is very weak in developing countries.

Globally scientific evidence has shown that low utilization of FAN services is influenced by some factors such as low maternal education, teenage pregnancies, multiparty, unplanned pregnancies and cultural factors (Simkhada et al., 2008). The main reasons that hinder the use of Antenatal Care are different from Country to Country. But the reason experienced in developing countries are nearly similar such as; hemorrhage, followed by eclampsia, infection, abortion complications and obstructed labor. Other issues are lack of knowledge and preparedness about reproductive health in the family, community and health provider (Ochako et al., 2011)To alleviate such factors, Antenatal Care is the most important method for detecting pregnancy problems in the early period. Because Antenatal care is the best mechanism to minimize maternal mortality, and give a good information for pregnant women about their birth and how to prevent related problems. The best and most advantage of Antenatal Care is to protect the health of women’s and their infants as well as indicating the danger signals that will be occurred and needs to be further treated by advanced health professionals (Effendi et al., 2018). A number of studies indicate that the Antenatal Care utilization rate is still low due to many factors that need to be examined such as socio demographic factors, knowledge of social support. They conclude that eliminating such factors is important to increase the women’s participation in Antenatal Care.

When we come to Cameroon, although, access to health care services is improving, the country has faced challenges in increasing healthcare utilization and the proportion of women who give birth with the assistance of skilled attendants is the lowest in Sub-Saharan Africa (Regassa et al., 2011). Knowledge of pregnant mothers’ maybe a major factor in determining the extent of antenatal services use. Reports from various parts of the world have shown that increased levels of awareness of pregnant mothers in terms of antenatal care have an impact on their utilization (Okafor et al., 2016). A lot of initiatives are in place to encourage adequate FANC utilization, these include: capacity building of health care providers towards AN Guideline and intensive information, education and communication (IEC) on maternal health services offered in all health facilities. It is worrying that despite availability of the reproductive health policy and initiatives promoting adequate utilization of FAN services, very few pregnant women utilize these services (Akhtar et al., 2018). Therefore, this study aimed to assess the aimed knowledge and attitude towards antenatal care among pregnant women attending for antenatal care in the Mutengene Community.

1.2. Statement of the Problem

The Sub-Saharan African region alone accounts for two-thirds (196,000) of maternal deaths across the world (UNICEF, 2019). In the context of Cameroon, the maternal mortality ratio (467per 100,000 live births) and infant mortality rates (48 per 1000 live births) remain extremely high despite numerous efforts put forth by government and NGOs (CDHS, 2018). These disturbing rates are partly due to the low AN coverage rates (65.0% attended at least 4 ANC visits) observed in Cameroon (WHO, 2020). The case is not different in the Mutengene Community of the Tiko, Sub Division. The level of knowledge and attitude of pregnant women is plagued with factors that influence the uptake of ANC services. For instance, pregnant women share an unhealthy attitude that they can go through their pregnancy without ANC service until birth. To them, this helps reduce the money spent in hospitals and they prefer to manage their pregnancies at home with traditional guides. This shows that they have low knowledge and poor attitude which is a serious concern. Some only rush to the hospital when they face serious complications.

Furthermore, because other women succeeded to go through their pregnancies to birth without ANC, couples are buying this poor attitude in the disguise of reducing cost. This is a serious problem that needs to be addressed and these issues prompted our current study on ‘knowledge and use of antenatal care services among  pregnant women within the Mutengene Community.

1.3. Rationale

The fate of the human population hangs on the ability to reproduce new offsprings that are healthy and cared for by healthy mothers. This shows that human reproductive health is a fundamental priority that have to be taken with serious care. In order to make this goal a reality, pregnant women and their babies have to be in good health before and after birth thus making ANC a top priority. Taking the above issues into consideration, it can therefore be concluded that poor knowledge and poor use of ANC service is serious threat to our future especially with the outbreak of diseases. There is therefore a need to improve pregnant women’s knowledge and use of ANC services . In this way, pregnant women will be motivated enough to overcome their reluctance to ANC and increase their and babies chance of survival. Therefore, the aim of this study is to assess knowledge and use of ANC services among pregnant women within the Mutengene community.

1.4 Research questions

1.  What level of knowledge do pregnant women have on ANC services in the Mutengene Community?.

2. What are the factors hindering pregnant women from attending ANC in the Mutengene Community?

1.5   Objectives

 

1.5.1. Main objective

The main objective of this study is to assess knowledge and use of ANC  services among pregnant women within the Mutengene Community.

1.5.2 Specific Objectives

1. To assess the level of knowledge pregnant women have on ANC services in the Mutengene Community.
2. To identify the factors hindering pregnant women from attending ANC in the Mutengene Community .

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