ABSTRACT
Antenatal
care is a key strategy for reducing maternal and neonatal morbidity and
mortality rate because adequate utilization of antenatal health care services
is associated with improved maternal and neonatal health outcomes. This study
aimed at determining the relevance of antenatal among pregnant woman in the
hospital, Ife Central Local Government Area, Osun State, Nigeria. Stratified
sampling technique was used among pregnant women from Ife Central Local
Government Area of Osun State, Nigeria. . Data were collected using a
questionnaire, a total number of 40 questionnaires were distributed among the
pregnant women attending antenatal in a particular hospital at Ife local
government and presented using a tables
CHPTER ONE
1.0 INTRODUCTION
Pregnancy
is one of the most important periods in the life of a woman, a family and a
society.
Extraordinary
attention is therefore given to antenatal care by the health care systems of
most countries. The goal of antenatal care is to prevent health problems in
both infant and mother and to see
That
each newborn child has a good start. The care provided needs to be appropriate
and not excessive.
New
technologies need to be implemented continually, while older services need to
be reconsidered.
The
care for each pregnant woman needs to be individualized based on her own needs
and wishes.
Antenatal
care, for purposes of this report, is all the care that a pregnant woman
receives from
organized
health services (2). The primary aims of this care are to:
•
detect early factors that may heighten the perinatal risk of both individual
pregnancies and
members of vulnerable groups;
•
intervene to improve outcomes;
•
educate all who provide or receive care; and
•
help make pregnancy and birth a positive life experience.
Antenatal
care includes planning for pregnancy and continues into the early neonatal and postpartum
period.
Health services generally consider that it begins with a pregnant woman’s first
visit to receive
antenatal
care and continues until birth. The model of antenatal care in Western Europe,
North America
and
many other countries includes 12-16 visits to health care services by the
pregnant woman, as well
as
provider visits to her home. The first visit ordinarily focuses on taking a
detailed social, family,
medical
and obstetric history, carrying out a complete physical examination, and making
a risk
assessment,
which requires a broad range of laboratory tests. Subsequent visits include
simpler
Examinations,
though some examinations are still conducted at every visit. Later in pregnancy,
examinations focus on the status of the developing fetus and the preparation
for a safe delivery.
An
increasing number of complex examinations and interventions are becoming part
of modern Antenatal care. Besides all of these examinations and the treatment
of any adverse conditions found,
the
pregnant woman may also receive health education and psychological and social
support from the
health
services. As a result, the average pregnant woman in many countries receives
150 or more
specific
tests/examinations/interventions during pregnancy. This broad range of options
makes
evaluation of antenatal care a challenge.
It
is generally assumed that antenatal care succeeds in meeting its goals
The
United Nations estimates that 529 000 women die each year from complications
during pregnancy and childbirth [AbouZahr & Wardlaw, 2004]. In Nigeria, it
is estimated that approximately 59,000 of maternal deaths take place annually
as a result of pregnancy, delivery and post delivery complications [WHO,
UNICEF, UNFPA, 2007] despite the available antenatal health care services. A
Nigerian woman is 500 times more likely to die in childbirth than her European
counterpart. Mortality ratio is about 800- 1,500/100,000 live births with
marked variation between geo-political zones- 165 in south west compared with
1,549 in the North- east and between urban and rural areas [NDHS, 2003; NPC,
2008]. Each year, about 6 million women become pregnant; 5 million of these
pregnancies result in child birth [WHO, UNICEF, UNFPA, 2007]. Antenatal care
refers to the care that is given to an expectant mother from the time that
Onasoga, Olayinka A. et al Adv. Appl. Sci. Res., 2012, 3(3):1309-1315
No conception is confirmed until the beginning
of labor [Viccars, 2003]. Adequate utilization of antenatal health care
services is associated with improved maternal and neonatal health outcomes.
Antenatal care is expected to have impact on the development of the fetus and
the infant as well as mother and this can only be achieved through early
booking and regular attendance of antenatal clinic.The trend of maternal mortality
in developing countries has been increasing and various international
organizations have reported that an important factor related to maternal and
infant mortality has been linked to lack of antenatal care [Villar, et al.
2001]. According to Federal Ministry of Health [2005], some of the dangers of
pregnancy and childbirth can be avoided if the pregnant woman attends antenatal
regularly. In order to decrease these mortality rates, regular antenatal care
has to be instituted or reinforced which can only be achieved through
identifying factors causing poor utilization of antenatal care services.
According
to WHO [2001] only 60% of women receive antenatal care in Nigeria, and not all
of them attend the antenatal clinic regularly [Villar et al., 2001]. A study
reported that with maternal risk held constant, low birth weight, and infant
mortality were 1.5-5 times higher with late and less frequent antenatal care
than with early and frequent care [Quick, Greenwick & Reghman, 1991]. A
study carried out on reproductive health issues showed that in 69% of the
recorded births, the mothers made 4 or more antenatal visits, while 20% made
fewer than 4 visits and 6.3% did not attend at all which is contrary to WHO
recommendation of 12 visits [Villar et al., 2001]. This shows that there are
marked differential in the use of antenatal and same as been observed in Ife
Central Local Government Area of Osun State Nigeria. Thus giving rise to the
need to identify the factors influencing the utilization of antenatal clinic among
pregnant women in Ife Central LGA, Osun State Nigeria
1.1 BACKGROUND OF THE STUDY
Antenatal
care (ANC) coverage is a success story in Africa, since over two-thirds of
pregnant women (69 percent) have at least one ANC contact. However, to achieve
the full life-saving potential that ANC promises for women and babies, four
visits providing essential evidence based interventions – a package often called
focused antenatal care – are required. Essential interventions in ANC include
identification and management of obstetric complications such as preeclampsia,
tetanus toxoid immunization, intermittent preventive treatment for malaria
during pregnancy (IPTp), and identification and management of infections
including HIV, syphilis and other sexually transmitted infections (STIs).
In 1904. Ballantyne
justified this work in an internationally anatomist-dominated field by
highlighting the obstetrician’s advantage, that only he could compare the
health of the mother during pregnancy with that of her fetus or child. He
claimed that the obstetrician’s familiarity with his patient, her family and
her social circumstances enabled him to construct a pathological genealogy for
any given case. While obstetricians had long dissected fetal anomalies,
preserved them for anatomical museums and reported them in journals, Ballantyne
insisted that the systematic collection of case histories by obstetricians
would make teratology clinically relevant. By framing clinical histories as a
crucial component of the investigation of fetal anomalies, and stressing the
importance of the medical management of pregnancy, he promoted a new
discipline: ‘antenatal pathology and hygiene’. Positioned between obstetrics
and teratology. Ballantyne initially struggled to find an audience for his
project. He first attracted serious attention from the medical profession by
appealing, in a 1901 article in the British Medical Journal, for the
establishment of a “pre-maternity hospital”. Unlike existing maternity
institutions, which generally turned away preparturient women, this would
accept patients in any stage of pregnancy diagnosed with complications or
abnormal obstetric histories. In October 1901, the directors of the Edinburgh
Royal Maternity Hospital set aside a bed, and later a ward, for the reception
of “patients suffering from the diseases incident to pregnancy”. Traumatic
experiences in past pregnancies, personal brushes with death during delivery,
or slow and incomplete post-partum recoveries may have prompted women to seek
medical attention, and to welcome the advice and reassurance provided by
hospital staff. Many local practitioners came to view the pre-maternity ward as
such women’s only hope of delivering a living child. The novelty of the
pre-maternity lay in Ballantyne’s suggestion that the expectant mother should
be subject to clinical observation and management “on behalf of her unborn
child”. He reasoned that the pre-maternity would enable obstetricians to
undertake the “systematic and scientific investigation of the bodily functions
in pregnancy”. This included the aetiology of congenital diseases,
malformations and miscarriages in the clinic by, for instance, experimenting
with therapeutic and dietary regimens and routinely examining stillbirths by
post mortem. Obstetricians elsewhere adopted Ballantyne’s agenda by campaigning
for clinical research in the pathology of pregnancy.
1.2
STATEMENT OF THE PROBLEM
While
writing the project work. The researcher encountered many problems. Among which
is the negative attitude of individual in the sense that people living in the
area of the study feel reluctant to give necessary information to help the
written of the project, it also give out for a long time to gather some
relevant information due to level of education of the people living in the
environment.
Another
problem encountered in the process of writing this project, the financial
constraint is also one of the problems that affect the written of the research
work. A time factor is also part of short coming in build-up of the project.
1.3 OBJECTIVE OF THE STUDY
The
main objective of this research work is assessing the relevance of Antenatal among
the Pregnant Women in the Hospital in Ife local government of Osun state;
•
To understand the trend of utilization of antenatal care services by pregnant
women in Ife Central local government area, Osun State.
•
To assess the level of knowledge of pregnant women about antenatal care
services in Ife Central local government area.
•
To determine the factors influencing the utilization of antenatal care services
among pregnant women in Ife Central local government area.
To
create a high level of awareness about the important of antenatal among the
pregnant women living in Ife local government Area.
1.4 SIGNIFICANCE OF STUDY
This
study will enable the pregnant women living in Ife local government understand
and have full knowledge of the relevance and important of antenatal on both
their health and their babies also will enable the health care professional to
determine the factors causing poor or irregular utilization of antenatal care
services and how to eradicate it. It will also help the government to develop
and implement new policies towards encouraging pregnant women to have free
asses to antenatal care services, which will help to reduce maternal and
neonatal morbidity and mortality rates, especially in Ife local government area of
osun state.
1.5 RESARCH
QUESTION
This aspect is designed and formulated to
further investigate on the topic.
1. Does
government contribute towards encouraging pregnant women towards ensuring free
antenatal services in ife local government?
2. Is
there any challenge faced by women during attending antenatal program in ife
local government?
3. Does antenatal has any effect on safe
delivery?
4. What is the level of awareness of antenatal
in Ife local government?
5. Does pregnant women have any knowledge
about antenatal program in Ife local government area of osun state?
1.6 SCOPE OF
THE STUDY
The
research was carried out only in Ife local government area of osu state. As
geographical coverage, the writer intended to have studied more than that, but
because of financial commitments of the writer and the extra time that would be
allotted in attempt to assess the relevance of antenatal among pregnant women
alone hindered the researcher in going further or more than this. The content
of the study focuses on the relevance of antenatal among pregnant women in Ife
local government area of osun state.
1.7 LIMITATIOS OF THE STUDY
The
research study is limited to IFE LOCAL GOVERNMENT AREA OF OSUN STATE and also
due to time factor and financial constrain in gathering more information the
research is strictly focused only on the subject matter of the project.
1.8 DEFINATION OF TERMS
Disease: - Is any deviation in the normal functions of
the body
Infection: - Infection is the early and multiplication of
the particular pathogenic organism (infection agent) in the body of man or
animal
Chemoprophylaxis: - The administration of chemical including
antibiotics to prevent the development of an infection or the progression of an
infection to active manifest disease, or to eliminate the carriage of a
specific infection agent to prevent transmission and disease in others,
chemotherapy on the other hand, refers to use of chemical to treat a clinically
manifest disease or to limit it further progress (JC infect Dis 2009)
Communicable disease: - All illness due to a specific infection
agent or it toxic product from an infected person, animal or inanimate
reservoir to a intermediate plant or animal host vector or the inanimate
environment (Alexander JR. Feb. 2009)
Sign and symptoms: - This refers to the general clinical feature
of a disease.
Diagnosis: - This is the recognition of the disease by its
clinical and symptoms
Encephalopathy: - A general term describing function. Examples
includes encephalitis- meningitis, seizures and head trauma (Pallansch Ma)
January 2009.
Epidemiology: - This is the study of all aspects of disease
including the spread, distribution and factors favoring such spread and
distribution within human population.
Sign and symptoms: -This refers to the general clinical features
of a disease.
Spinal polio: - Is the most common form of paralytic,
poliomyelitis results from viral invasion of the motor neurons othe anterior
horn cells, or the ventral (front) grey matter section in the spinal column,
which are responsible for movement of the muscle, including those of the trunk,
limbs, and the intercostals muscles.
Poliomyelitis: - Poliomyelitis often called polio or infantile
paralysis is an infectious disease caused by the polio-virus. A.
Antigen: - Foreign substances (e.g. bacteria and
viruses) in the body that are capable of causing disease. The presence of
antigen in the body triggers an immune response usually the production of
antibodies (Atkins son W mar 1986)
CHAPTER TWO
LITERATURE REVIEW
Labour and delivery is
the end of pregnancy and beginning of new life. Antenatal care plays an
important role to achieve a successful labour and delivery process. Regular
antenatal classes help in the physical and mental preparation of women and help
them relax during those last months. Antenatal care ensures maternal foetal
health wellbeing and also prepares women physically fit for labour, delivery
and the postpartum period.
Regular visits to the
doctor during pregnancy are aimed to ensure that the health of the pregnant
women and the growing foetus is well maintained. When all stays well and proper
care is taken, the pregnancy is generally low risk.
Normal labour and
delivery depend on good physical and mental preparation during the antenatal
period. The pregnant woman is taught good breathing exercises, relaxation
techniques and muscle toning exercises.
At about 36 weeks
gestation the mode of delivery should be discussed with your doctor. If the
decision is taken to proceed with normal labour vaginal delivery, then regular
visits are continued till labour starts. These weekly visits ensure that all is
well and thus it is important to feel good foetal movements during this time.
When labour begins get
ready to go to hospital. Do not take heavy meal as there is risk of vomiting
when pains get strong and this will get worse if your stomach is full. Liquids
are the best form of intake from now on and they are good for rehydration. You
will urinate frequently, this is normal. Take as much as rest possible so that
you can cope with active labour. Preferably lie down on your left side. When
awake it is good to move around. When contractions get stronger and frequent it
will be difficult to cope and you will have to go to hospital.
ANC
is also an opportunity to promote the use of skilled attendance at birth and healthy
behaviors such as breastfeeding, early postnatal care, and planning for optimal
pregnancy spacing.
Many
of these opportunities continue to be missed, even though over two-thirds of
pregnant women receive at least one antenatal visit. How can we strengthen ANC
to provide the priority interventions, especially given Africa’s current critical
shortage of human resources for health? Are there particular barriers or
challenges to increasing coverage and quality that could be overcome? How can
the multiple programmes that rely on ANC –malaria, HIV/AIDS, tetanus
elimination, control of STIs – be integrated and strengthen the “vehicle” of
ANC, rather than adding to the current overload?
Preventing
problems for mothers and babies depends on an operational continuum of care
with accessible, high quality care before and during pregnancy, childbirth, and
the postnatal period. It also depends on the support available to help pregnant
women reach services, particularly when complications occur.
An
important element in this continuum of care is effective ANC. The goal of the
ANC package is to prepare for birth and parenthood as well as prevent, detect,
alleviate, or manage the three types of health problems during pregnancy that affect
mothers and babies:
•
Complications of pregnancy itself
•
pre-existing conditions that worsen during pregnancy
•
Effects of unhealthy lifestyles
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 behaviors
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 affects both women
and babies:
EFFECTS OF ANTENATAL ON MOTHERS:
It
has been estimated that 25 percent of maternal deaths occur during pregnancy, with
variability between countries depending on the prevalence of unsafe abortion,
violence, and disease in the area.
Between
a third and a half of maternal deaths are due to causes such as hypertension
[1]
(Pre-eclampsia and eclampsia) and ante partum hemorrhage, which are directly
related to inadequate Care during pregnancy.
In
a study conducted in six west African countries, a third of all pregnant women
[2]
Experienced illness during pregnancy, of whom three percent required hospitalization.
[3]
pre-existing conditions become more severe during pregnancy. Malaria, HIV/AIDS,
anaemia and
malnutrition
are associated with increased maternal and newborn complications as well as
death where
the
prevalence of these conditions is high. New evidence suggests that women who
have been subject to female genital mutilation are significantly more likely to
have complications during childbirth, so these women need to be identified
during ANC.
[4
] Gender-based violence and exposure to workplace hazards are additional and often
underestimated public health problems. Rates of depression may be at least as high,
if not higher, in late pregnancy as during the postnatal period. Some African
societies believe that grieving for a stillborn child is unacceptable, making
the death of a baby during the last trimester of pregnancy even harder to
process and accept.
EFFECTS OF ANTENATAL ON BABIES:
In
sub-Saharan Africa, an estimated 900,000 babies die as stillbirths during the
last twelve weeks of pregnancy. It is estimated that babies who die before the
onset of labour, or ante partum stillbirths, account for two-thirds of all
stillbirths in countries where the mortality rate is greater than 22 per 1,000
births – nearly all African countries.6;7Antepartum stillbirths have a number
of causes, including maternal infections – notably syphilis – and pregnancy
complications, but systematic global estimates for causes of ante partum stillbirths
are not available.
Newborns
are affected by problems during pregnancy
including
preterm birth and restricted fetal growth, as well as other factors affecting
the baby’s development such as congenital infections and fetal alcohol
syndrome.
The
social, family, and community context and beliefs affect health during
pregnancy either positively or negatively. Some cultures promote special foods
and rest for pregnant women, but in others, pregnancy is not to be
acknowledged. In these cases, women continue to work hard, and nutritional
taboos may deprive them of essential nutrients, adding to nutritional deficiencies,
particularly iron, protein, and certain vitamins. In one tribe in Nigeria,
pregnant women cannot say they are pregnant, and if they feel unwell, they have
to say that they have “swallowed a cockroach.”
THE ESSENTIAL ELEMENTS OF A FOCUSED APPROACH
TO ANTENATAL CARE AMONG PREGNANT WOMEN
•
Identification and surveillance of the pregnant woman and her expected child
•
Recognition and management of pregnancy-related complications, particularly
pre-eclampsia
•
Recognition and treatment of underlying or concurrent illness
•
Screening for conditions and diseases such as anaemia, STIs (particularly
syphilis), HIV infection, mental health problems, and/or symptoms of stress or
domestic violence
•
Preventive measures, including tetanus toxoid immunization, de-worming, iron
and folic acid, intermittent preventive treatment of malaria in pregnancy
(IPTp), insecticide treated bed nets (ITN)
•
Advice and support to the woman and her family for developing healthy home behaviors
and a birth and emergency preparedness plan to:
During pregnancy, women
are offered a range of tests, including blood tests and ultrasound baby scans.
These tests are designed to help make pregnancy safer, check and assess the development
and wellbeing of mother and the baby, and screen for particular
conditions.
You don't have to have
any of the tests. However, it's important to understand the purpose of all
tests so that you can make an informed decision about whether to have
them.
RELEVANCE
OF ANTENATAL ON PREGNANT WOMAN
Weight
and height checks in pregnancy
Weighed at your booking appointment, but no
weighed regularly during pregnancy. Height and weight are used to calculate BMI
(body mass index). Women who are overweight for their height are at
increased risk of problems during pregnancy.
Most women put on
10-12.5kg (22-28lb) in pregnancy, most of it after they are 20 weeks
pregnant. Much of the extra weight
is due to the baby growing, but body also stores fat for making breast milk
after the birth. During pregnancy, it's important to eat the right
foods and do regular
exercise.
Antenatal
urine tests
You'll be asked to give
a urine sample at your antenatal appointments. Your urine is checked
for several things, including protein or albumin. If this is found in your
urine, it may mean that you have an infection that needs to be treated. It may
also be a sign of pre-eclampsia.
Pre-eclampsia affects 5%
of pregnancies and can lead to a variety of problems, including seizures
(fits). If left untreated it can be life threatening. Pre-eclampsia can also
affect the growth and health of the baby. Women with the condition usually
feel perfectly well.
Blood
pressure tests in pregnancy
Blood pressure will be
taken at every antenatal visit. A rise in blood pressure later in
pregnancy could be a sign of pregnancy-induced hypertension. It's very common
for your blood pressure to be lower in the middle of your pregnancy than at
other times. This isn't a problem, but it may make you feel lightheaded if you
get up quickly. Talk to your midwife if you're concerned about it. Find out
more about high blood
pressure and pregnancy.
Blood
tests in pregnancy
As part of antenatal
care you'll be offered several blood tests. Some are offered to all women, and
some are only offered if you might be at risk of a particular infection or
condition. All the tests are done to make your pregnancy safer or to check that
the baby is healthy, but you don't have to have them if you don't want to.
Talk to your midwife or
doctor and give yourself enough time to make your decision. They will also
give you written information about the tests. Below is an outline of all
the tests that can be offered.
The blood tests you may
be offered include:
-
blood group
-
rhesus disease
-
anemia
-
diabetes
Blood group
It
is useful to know your blood group in case you need to be given blood, for
example if you have heavy bleeding (hemorrhage) during pregnancy or birth. The
test tells you whether you are blood group rhesus negative or rhesus positive.
Women who are rhesus negative may need extra care to reduce the risk of rhesus disease.
Rhesus disease
People who are rhesus positive have a substance known as D
antigen on the surface of their red blood cells. Rhesus negative people do
not. A rhesus negative woman can carry a baby who is rhesus positive if
the baby's father is rhesus positive. If a small amount of the baby's blood
enters the mother's bloodstream during pregnancy or birth, the mother can
produce antibodies against the rhesus positive cells (known as anti-D
antibodies).
This usually doesn't affect the current pregnancy, but if
the woman has another pregnancy with a rhesus positive baby, her immune
response will be greater and she may produce a lot more antibodies. These
antibodies can cross the placenta and destroy the baby's blood cells, leading
to a condition called rhesus disease, or hemolytic disease of the newborn.
This can lead to anemia and jaundice in the baby. Find out more about rhesus disease.
Anti-D injections can prevent rhesus negative women from
producing antibodies against the baby. Rhesus negative mothers who haven't
developed antibodies are therefore offered anti-D injections at 28 and 34
weeks of pregnancy, as well as after the birth of their baby. This is quite
safe for both the mother and the baby.
Anemia
Anemia makes
you tired and less able to cope with loss of blood when you give birth. If
tests show that you're anaemic, you'll probably be given iron and folic
acid.
Diabetes
You may be at higher risk of developing diabetes in
pregnancy (gestational diabetes) if you are overweight, you've had diabetes in
pregnancy before, you have a close relative with diabetes or you're of south
east Asian, black Caribbean or Middle Eastern origin.
If you're considered to be high risk for gestational diabetes,
you may be offered tests in
pregnancy including blood tests.
Blood
tests for infections in pregnancy
You'll be offered blood tests for:
·
Susceptibility to rubella (German
measles) – if you get rubella
in early pregnancy, it can seriously damage your unborn baby. Your midwife or
doctor will talk to you about what happens if your test results show low or no
immunity.
·
Syphilis –
you'll be tested for this sexually transmitted infection as it can lead to
miscarriage and stillbirth if left untreated.
·
Hepatitis B –
this virus can cause serious liver disease, and it may infect your baby if
you're a carrier or you're infected during pregnancy. Your baby won't usually
be ill but has a high chance of developing long-term infection and serious
liver disease later in life. Your baby can be immunized at birth to prevent
infection. If you have hepatitis B, you'll be referred to a specialist.
·
Hepatitis C –
this virus can cause serious liver disease and there is a small risk it will
pass to your baby if you are infected. It can't be prevented at present. Tests
for hepatitis C aren't usually offered routinely as part of antenatal care. If
you think you might be at risk, talk to your midwife or GP, who can arrange a
test. If you're infected, you'll be referred to a specialist and your baby can
be tested after it's born.
·
HIV (human
immunodeficiency virus) – this is the
virus that causes AIDS. HIV infection can be passed to a baby during
pregnancy, at delivery or after birth by breastfeeding. As part of your routine
antenatal care, you'll be offered a confidential test for HIV infection. If
you're HIV positive, both you and your baby can have treatment and care that
reduces the risk of your baby becoming infected.
Be aware that you can still catch all these infections during
pregnancy after you've had a negative test result. This includes sexually
transmitted infections such as syphilis, HIV and hepatitis B if you or
your sexual partner take risks, such as having unprotected sex. You
can also get HIV and hepatitis if you inject drugs and share needles. Your
midwife or doctor can discuss this with you.
Find out more about screening for
infectious diseases in pregnancy and potentially
harmful infections in
pregnancy.
HIV
infection in pregnancy
If you think that you're at risk of getting HIV or you know that
you're HIV positive, talk to your midwife or doctor about HIV testing and
counseling. You can also get free confidential advice from the Sexual
Health Line on 0300 123 7123, or you can talk
confidentially to someone at Positively UK on
020 7713 0222.
If you're HIV positive, your doctor will need to discuss the
management of your pregnancy and delivery with you.
There is a one-in-four chance of your baby being infected if you
and your baby don't have treatment. Treatment can significantly reduce
the risk of transmitting HIV from you to your baby. One in five HIV-infected
babies develops AIDS or dies within the first year of life, so it's important
to reduce the risk of transmission.
Your labour will be managed in order to reduce the risk of
infection to your baby. This may include an elective caesarean
delivery.
Your baby will be tested for HIV at birth and at intervals for
up to two years. If your baby is found to be infected with HIV, pediatricians
can anticipate certain illnesses that occur in infected babies and treat them
early. All babies born to HIV positive mothers will appear to be HIV positive
at birth, because they have antibodies from their mother's infection. If the
baby is not HIV positive, the test will later become negative because the
antibodies will disappear.
You'll be advised not to breastfeed as HIV can be transmitted to
your baby in this way.
CHAPTER THREE
3.0 RESESARCH METHOLOGY
3.1 DESIGN OF THE STUDY
The
main purpose of this project is to carry out a study on the relevance of
antenatal on pregnant women in the hospital in Ife local government area of
Osun State Nigeria.
Data
collection in any research is very important aspect for the research to obtain
adequate data collection for the purpose and to collect reliable information
about the topics the research is carried out.
3.2 STUDY POPULATION
The
population for this study comprises of entire women more especially the
pregnant women attending antenatal in Ife local government Osun State.
3.3
DESCRIPTION OF STUDY AREA
The
sample used is sample randomly techniques, pregnant women were chosen by sample
random techniques in the hospital at Ife local government area of osun state.
The
questionnaires produce is 40 copies, 30 copies of the questionnaires to the pregnant
women and about 10 copies to nursing mothers. Some were chosen for interview by
random sampling and the community seen for observation.
3.4 CRITERIA FOR SAMPLE COLLECTION
The reason for the sampling is
because all the pregnant women cannot be
chosen for the study due to their population using random sampling techniques.
The acts have equal chances of being chosen for the study.
3.5 RESEARCH INSTRUMENT
Different
instrument were used in collecting facts on this study, the following were the
instruments used.
ü Questionnaires
ü Interview
ü Observation
3.6 METHOD OF DATA ANALYSIS
- The data collected through various researches cannot do without coming across some difficulties, some of which are highlighted as follows:
- 1) Lack of co operation on the part of some pregnant women sample for the interview
- 2) Lack of education on the part of some of the pregnant women to complete questionnaires
- 3) The distance covered which make the researcher spent more money than initially budgeted for.
CHAPTER FOUR
4.1 DATA ANALYSIS AND PRESENTATION
The researcher of this project has
distributed 40 questionnaires to the pregnant women between the ages of 25
years and 40 years.
TABLE 1: SHOWING THE FREQUENCY OF AGE
DITRIBUTION OF THE RESPONDENTS
AGE GROUP
{YEARS}
|
NUMBERS OF RESPONDENTS
|
PERCENTAGE
|
30 – 35
|
10
|
25%
|
35 – 40
|
25
|
62.5%
|
40 and above
|
5
|
12.5%
|
TOTAL
|
40
|
100%
|
Table
one above show the age distribution of the forty respondents selected among the
pregnant women age 10{25%} respondents
were between the age of 30 and 35, while 25{62.5%}respondents representing the
total respondents were between the age of 35 – 40 years. The remaining 5{12.5%}
were also between the age of 40 years and above. Bringing the total respondents
to 100%.
TABLE
2: SHOWING THE MARITAL STATUS OF THE RESPONDENTS IN ILORIN METROPOLY {EAST,
SOUTH AND WEST}
MARITAL
STATUS
|
NO: OF
RESPONDENTS
|
PERCENTAGE
|
Married
|
40
|
100%
|
Separated
|
-
|
-
|
Single
|
-
|
-
|
Total
|
40
|
100%
|
Table
two above shows that 40 {100%} of the respondents were still in their marital
homes while no separated and single women among them.
Table three; Does government contribute
towards encouraging pregnant women towards ensuring free antenatal services in
ife local government?
OPTION
|
NUMBER OF
RESPONDENTS
|
PERCENTAGE
|
YES
|
35
|
87.5%
|
NO
|
5
|
12.5%
|
TOTAL
|
40
|
100%
|
Table three shows that 35 respondents which
represent [87.5%] said Yes while only 5 respondents representing [12.5%] said
No which implies that government has contributed in ensuring free antenatal
services in Ife local government of Osun state.
TABLE
4: Is there any challenge faced by women during attending antenatal program in
ife local government?
SOURCE OF
INFORMATION
|
NO: OF
RESPONDENTS
|
PERCENTAGE
|
Yes
|
30
|
75%
|
No
|
5
|
12.5%
|
I don’t know
|
5
|
12.5%
|
Total
|
40
|
100%
|
The
table is reflecting that the respondents 30 representing {75.5} responded Yes.
5 respondents {12.5%} responded No while the remaining 5 {12.5} of respondents responded
that they don’t know. This shows that there are challenges militating against
antenatal in Ife local government of Osun State.
TABLE 5: Does antenatal has any effect on safe
delivery?
TARGET GROUP
|
NO: OF
RESPONDENTS
|
PERCENTAGE
|
Yes
|
35
|
87.5%
|
No
|
2
|
5%
|
No idea
|
3
|
7.5%
|
Total
|
40
|
100%
|
Table
five shows that 35 respondents representing [87.5%] responded Yes while 2
respondents representing [5%] said No and the other 3[7.5%] respondents
responded no idea this shows that antenatal has effect on safe delivery.
TABLE 6: What is the level of awareness of antenatal in
Ife local government?
OPTION
|
NO: OF
RESPONDENTS
|
PERCENTAGE
|
High
|
40
|
100%
|
Low
|
0
|
0%
|
TOTAL
|
40
|
100%
|
The
above table show that all the respondents said that the level of awareness is
high in Ife local government of osun state.
TABLE 7: Does pregnant women have any
knowledge about antenatal program in Ife local government area of osun state?
OPTION
|
NO: OF
RESPONDENTS
|
PERCENTAGE
|
YES
|
25
|
62.5%
|
NO
|
15
|
37.5%
|
TOTAL
|
40
|
100%
|
From the above table: shows that 25 respondents representing [6.5%] while
15
Respondents
representing [37.5] responded No, this implies that pregnant women have
knowledge of antenatal in Ife local government area of osun State.
CHAPTER FIVE
5.0 DISCUSSION OF REPORT
In this chapter, the researcher
attempted to discuss about bone of the contention together with the findings
gathered from the administered questionnaires, personal interview and acute
observation of the targeted population in IFE LOCAL GOVERNMENT AREA OF OSUN
STATE NIGERIA.
Hence the study attempts mainly and
particularly to assess the relevant of antenatal among the pregnant women in
the hospital at Ife osun state.
Particularly, Nigeria is one of the developing
countries in which antenatal program is very poor and as result cause the death
of thousands of women before or during child delivery every year. And this
resulted from various disease that are preventable but due to number of reasons
on the part of the government in general, these innocent women lives were
destroyed.
Furthermore, the researcher took
pains to conduct personal interview and also to engage in physical observation
in conjunction with the administered questionnaires to the concern women in the
area in order to be informed about the great impact or relevance of antenatal
program in the local government area of the state.
There
is a need to clarify the number of the women that were involved in the process
to put these pieces of information together, the majority of the respondent to
our questionnaires and even the interview and observation were females, almost
38% of the total populace in the local government area.
The questionnaire revealed that the
rate of the awareness of antenatal program in the area is represented by 35% of
the total respondents. Going by the percentage of the awareness of the program
been in bided by pregnant women shows that they are ready to participate which
has assisted in reducing the number of cries in the area to the barest minimum.
Furthermore, the respondents showed us that
the importance of the antenatal program to the people of the community is very
remarkable and encouraging.
To crown it all almost all the respondents
believed that the antenatal program importance to their well – being and will
also prevent their babies killed by the major deadly or killer disease. 38% of
the women in the area normally attend the antenatal program. This is revealed
by the respondents it is evident that women in the area seriously interested
and ready to participate in the program to ensure their safety and health being
during pregnancy and after delivery.
Finally, without being exaggerated almost
every individual woman in Ife osun state reacted positively and ready to
participate in the antenatal program which could be seen in 39% out of
aggregated populace in the area.
5.1 CONCLUSION
Antenatal
care is an essential part of modern health care. Any health care programme that
sincerely
wishes
to improve the health of its population must pay serious attention to the
health of the pregnant
woman
and her fetus. Such care is every woman’s right.
1.
Antenatal care is one of the most important health care services. Every
pregnant woman needs full
access
to antenatal services, which also need to be organized and paid for. In
addition, it is
desirable
that they be monitored periodically to assure appropriateness and high quality.
The most
Cost-effective
model of care thus far demonstrated is that provided to a low-risk pregnant
woman
by
a midwife. The new WHO model of antenatal care presents a detailed plan for
cost-effective
care
for women with uncomplicated pregnancies (see Annex 3).
2.
Excessive, unneeded and unproven interventions are often provided to women with
normal
pregnancies.
Services can by considerably reduced in such cases without any health
consequences
and
with potential monetary savings. Conversely, research during the last 20 years
has
demonstrated
the value of certain routine services that should always be part of antenatal
care.
3.
Many interventions in antenatal care still have not been evaluated. The
potential for research in
this
field remains large. Research needs to focus on factors that identify high-risk
pregnancies and
on
the health benefits of specific interventions, both old and new
5.2 RECOMMENDATION
I commend
all the effort put forward by the united nation international children
emergency fund [UNICEF]. The world health organization [WHO]. The federal
government of Nigeria and also state government in particular, their various
effort to ensure a successful antenatal program for pregnant women that led
many into high and healthy condition it has reduced the morbidity rate among
pregnant women in the country. The local government too cannot be left over in
that they utilized all material and money that was allocated for antenatal
program wisely.
Now, I will like to appeal to the
federal government and other organization taking part in the better running of antenatal
program to please help in improving the program for better service delivery in
the rural
Also both the federal, state and
local government can help in providing enough vehicles so that the remote areas
may be reached during the program days and other days when are need arises.
The government can also employ or
train more staff so that the people will be deployed less when they came for antenatal.
Lastly
proper program should be arranged for a special lecture delivery to women on
the importance and the need for antenatal before, during and after delivery.
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Stwart
F.B Beswick T. S. L: Bacteria, viro
and immunization for
student of medicine
Meredith
Davies J.B: Community Health,
Preventive
Medicine & Social
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Ballianet
al [1984] Child Health: A Manual For Medicine Assist
Ance and other rural health
Workers
Mondi
P.E UNICEF [1985]: Universal Child Immunization
Blooma
And Blooma [1986]: Tooheys Medicine For Nurses
Myles
M.F [1993]: Text Book For Mid – Wives, 12th Edition
Longman Group Limited And Churchill
Living
stone Page 708-709
World Health Organization: Expanded Program On
Immunization
Six
Common Childhoods Diseases
Published
by Federal Government
Press
Federal Ministry Of Health: Primary Health
Workers Lagos
Abamo
Press
Immunization Desk Reference: By Federal
Ministry Of Health
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