Abstract

Antenatal care is one of the strategies aimed at addressing maternal mortality as it facilitates the identification and avoid pregnancy related problems and saves lives of mothers and babies. This result has an objective which is to determine the Factors influencing the utilization of ANC services by pregnant women; the research was carried out at the Buea Regional Hospital, during the period of study from Feb 2023 – March 2023.

A cross sectional descriptive research design was used involving 57 pregnant women. Data analysis was done using Statistical Package for Social science version 23.0 for analysis (SPSS). The study involved a total of 57 respondents, of which 68.42% had adequate knowledge on antenatal care, with most of them getting ANC information from Health care provider. 70.18% defined ANC as a clinical assessment of mothers during pregnancy.

Also, 78.95% of the respondents believe that a pregnant woman with normal pregnancy should attend ANC at least 8 times before birth. Looking at the factors influencing utilization of ANC services, 52.63% of pregnant women believe that the attitude of Health care provider influenced them positively to attend ANC.

The study also shows that All the pregnant women had done Echography, followed by blood group, but less than half of pregnant women had done Hepatitis test, taken tetanus vaccine, Fansidar and Folic acid. In conclusion, Majority of the pregnant women had adequate knowledge (68.42%) as they could define, list the activities done during visits and the importance of ANC. Health authorities should apply strategies to attract and encourage the women to attend ANC, in other to enhance the utilization of the services.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background

Antenatal care is a type of preventive health care with the goal of providing regular check-ups that allow doctor or midwives/nurse to treat and prevent potential health problems throughout the course of pregnancy while promoting healthy life style that benefits both mother and child (Isatou et al, 2012). Around eight hundred and thirty women died every day from pregnancy related problems and child birth because they didn’t attend ANC. Almost all of this death occurs in developing countries (World Health Organization (WHO), 2015).

One of the aims of the Millennium Development Goal (MDG) is to reduce mother and child mortality and morbidity. Several deaths are mainly due to hemorrhage, eclampsia, infections, abortion, complication and obstructed labor. Another issue compounding maternal morbidity and mortality include lack of knowledge on the importance of Antenatal Care (ANC) by pregnant women. A good antenatal care is an important element in reducing maternal morbidity and mortality and thus providing pregnant women with a broad range of health promotion activities (Jallow et al., 2010).

Analytical review of the recent world health statistics shows that ANC coverage between 2006 and 2013 was directly correlated with maternal mortality ratio and this indicates that countries with low ANC coverage are countries with high maternal mortality rate. ANC coverage in united Arab emirate was 100% with 8 per 100.000 and Ukraine had 99%. In sub-Saharan Africa, Ghana had ANC coverage of 96% and maternal mortality rate of 980/100.000 (Kobinisky, 2013). ANC coverage in Cameroon in 2007 stood at 82% with 60% of pregnant women having four or more visits. Maternal mortality ratio has dropped by 47% worldwide during the past 9 years (WHO, 2010).

The WHO recommend minimum of eight visits for women with normal pregnancy that is one visit in each 1st and 2nd trimester and other visits in the 3rd trimester. Antenatal care encompasses pregnancy related services provided between conception and the onset of labor with the aim of improving pregnancy outcome and the health of the mother and child (WHO, 2013). The services provided during ANC are Education, Screening, counseling, treatment of minor ailment and immunization services.

According to the theoretical statement of Philuip (2013) despite the availability of services, accessing health care remains a problem in many developing countries, perinatal care has the potential to improve perinatal outcome and decrease health dispenses. Yet many women struggle with access to care.

Antenatal care is the care given to pregnant women in order to have a safe pregnancy and a healthy baby. Antenatal care is an important determinant of maternal mortality rate and one of the basic components of maternal care on which the life of mothers and babies depend. Thus, Antenatal care is a key strategy to improve maternal and infant health (Mary et al., 2016). Different studies have found that inappropriate antenatal care has been associated with adverse pregnancy outcomes (Ducic et al., 2012).

Several studies conducted in different countries on demographic and socio-cultural factors influencing use of maternal health care services, have shown that factors like maternal age, number of living children, education, place of residence, occupation, religion, ethnicity and household wealth are significantly associated with use of antenatal care, (Carolan et al., 2015).

Approximately 536,000 maternal deaths occur annually, of which over 95% occur in sub-Saharan Africa and Asia. Amongst WHO countries, globally 30% of women between the age group of 15-40 years do not have ANC, 46% of those who did not have ANC are in South Asia

While 34% are in sub-Saharan Africa. This low use of services leads to death and disability due to untreated hypertensive disorders or due to mal- or sub-nutrition like iron deficiency anemia. (Leonar et al., 2012),

The lower rate of ANC utilization and delivery assistance services has been established as contributing factors for higher rate of maternal mortality. In disadvantaged regions of the world like Ethiopia where such service is poorly developed, maternal mortality remained to be a big challenge in public health. To address these issues, different stakeholders at international, national, and regional levels have been implementing different strategies. The MDG has been one of the internationally coordinated biggest initiatives, (Cassar, 2012). Hence the objective of this study is to appraise the factors affecting antenatal care utilization among pregnant women in the Buea Regional Hospital.

1.2 Problem Statement

The importance of ANC cannot be underestimated because it would detect abnormalities, support, health guidance and offer guidance that will halt preventable illnesses in mother and child. The WHO recommends a minimum of eight visits per ANC for prenatal women but according to figures between 2010 and 2018, only 53% of pregnant women worldwide attend the recommended eight visits in (2018).

The maternal and infant mortality rate can be described as unacceptable. During an internship in Regional Hospital Buea it was realized that many pregnant women do not attend ANC regularly. This prompted the researcher to find out the factors affecting or influencing the utilization of antenatal care services amongst pregnant women in the Regional Hospital Buea.

1.3 Research Questions

1. What knowledge do pregnant women have on the importance of ANC in the Buea Regional Hospital?
2. What is the rate of uptake of ANC services amongst pregnant women in the Buea Regional Hospital?
3. What factors influence the utilization of ANC services amongst pregnant women in the Buea Regional Hospital?

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