ASSESSING THE KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN ON THE CONSUMPTION OF ALCOHOL

Abstract

Background: Alcohol exposure in pregnancy is a common and modifiable risk factor for poor pregnancy and child outcomes. Alcohol exposure in pregnancy can cause a range of physical and neurodevelopmental problems in the child including the Fetal Alcohol Spectrum Disorders (FASD). In order to improve prevention strategies, we sought to describe the knowledge, perception and effects of women of childbearing age regarding alcohol consumption during pregnancy and its effects on the fetus in the Tiko Community.

Methods: The study made use of quantitative design to sample 150 pregnant women using structured-questionnaire by means of a simple, random and convenient sampling techniques. Collected data were analysed descriptively using SPSS (25.0) along with bivariate analyses were used to assess associations with participant’s alcohol consumption and sociodemographic characteristics.

Results: of the women survey, 84.6% have been informed of the risk of consumption of alcohol to both mother and fetus, with only 27.7% been informed by health professional with the other where informed by friends and family members. 76.9% consumed alcohol during pregnancy. Most women agreed that pregnant women should not drink alcohol (65.4%) and 42.0% reported having negative feelings towards pregnant women drinking alcohol. Risk factors associated with alcohol consumption revealed that religion of respondents, educational level, marital status, and ANC visits were major factors associated with alcohol consumption among pregnant women.

Conclusions: The study concluded that the prevalence of alcohol consumption among pregnant women in the Tiko Community was very high. The study concluded that knowledge and awareness of the dangers of alcohol consumption during pregnancy in the Tiko Community were average, however, they are not aware of the risks for the baby, as they believed that alcohol is harmful to pregnant women and the fetus only when taken in huge quantities. There is a need for a future study on the impact of health education on the prevalence of alcohol consumption during pregnancy in the study population.

CHAPTER ONE

INTRODUCTION

1.0 Background of the Study

Among many countries in the world, women who are living in Chad, Namibia, Uganda, and Ethiopia are the highest alcohol consumers which are ranging from 17.7 to 24.5 l of pure alcohol per capita per year (WHO, 2014).

Different studies conducted in various settings in Africa countries reveal that the prevalence of alcohol consumption during pregnancy varies from 2.5% to 59.28% (Popova, 2016) which shows that a great discrepancy across different geographical settings and at different periods. In Sub-Saharan Africa, a great number of unplanned pregnancy, lack of awareness about the effect of alcohol consumption, having partners and friends consume alcohol, some health-related problems like depression and unemployment are the main factors for alcohol consumption during pregnancy (Abasiubong et al., 2015).

The use of drug is an old major public health problem. For several years, scientists and health care professionals and more specifically policy makers have undertaken various actions to reduce drug use among the general population.

However, the prevalence of drug use by pregnant women still remains a major concern according to the world health organization (WHO, 2018). Alcohol use during pregnancy has been confirmed for many years to be associated with negative effects on the mother and unborn child (National Bureau of Statistics, 2015). The effect of alcohol use during pregnancy is evident immediately after birth, during early or later life particularly when it damages the Central Nervous System (CNS) (Ordinioha et al., 2015). Limiting the exposure to alcohol is one of the modifiable risk factors for poor pregnancy outcomes (Isaksen et al., 2010).

Alcohol in the mother’s blood passes to the baby through the umbilical cord. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities. These disabilities are known as fetal alcohol spectrum disorders (FASDs) (Kessy et al., 2011).

During the 1990s, most Western countries officially recommended that pregnant women abstain from alcohol. However, information about the potentially harmful effects of alcohol during pregnancy does not necessarily equate to understanding, and information and knowledge may not be associated with pregnant women’s own attitudes toward drinking.

Moreover, the influence of alcohol consumption during pregnancy on offspring has received widespread research attention since early reports that prenatal alcohol exposure can have devastating and persistent consequences (Schneider, 2011).

Foetal alcohol syndrome (FAS) is the most widely known outcome of heavy drinking during pregnancy, but despite the health educative talks on the harm caused by drugs during pregnancy and their effect on unborn children, several women are still involved in these harmful habits during the prenatal phase (Nordmann, 2006).

Numerous research and studies have established the various outcome that heavy drug consumption (alcohol, and tobacco), or even moderate daily consumption of alcohol, with episodic drunkenness during pregnancy are likely to cause, such as; serious and irreversible damage to the foetus, growth retardation, premature delivery as well as mental disorders, poor brain development, reproductive, hormonal and immunological imbalance (Urso et al., 2010).

A recent study using data from the WHO’s World Health Survey observed diverse patterns of drinking among 20 African countries, supporting the contention there is a variety of national drinking habits across the African continent. Cameroon is a country characterized by both high alcohol intake and high prevalence of HIV (WHO, 2016).

Alcohol consumption in Cameroon is estimated to be 2.6 litres of pure alcohol per capita for men and women older than 15 years. About 41.4% of men and 25.8% of women consume alcohol regularly in Cameroon. Considering this public health concern, very few studies have been conducted in Cameroon, to address this issue on the prevalence of alcohol and tobacco consumption habits but rarely with regard to pregnant women knowledge and Practices, this study however would be a step-up contribution to the knowledge and Practices of pregnant women on the consumption of alcohol in the Tiko community.

1.2 Problem statement

In Sub-Saharan Africa, a great number of unplanned pregnancy, lack of awareness about the effect of alcohol consumption, having partners and friends consume alcohol, some health-related problems like depression and unemployment are the main factors for alcohol consumption during pregnancy (Abasiubong et al., 2015).

Alcohol exposure is one of the few modifiable risk factors for poor pregnancy outcomes. Fetal Alcohol Syndrome (FAS) was formally described only thirty-five years ago (Lemoine et al., 2003a) but the effects of alcohol consumption in pregnancy on the unborn child have been recognised for hundreds of years (Lemoine et al., 2003b).

Alcohol consumption in pregnancy has been associated with miscarriage (Maconochie et al., 2007), premature birth (Sokol et al., 2007), stillbirth, low birth weight, and diagnoses that are encompassed by the umbrella term of the Fetal Alcohol Spectrum Disorders (FASD). Children with FAS have characteristic facial features (small palpebral fissures, smooth philtrum and thin vermillion border of the upper lip), prenatal and/or postnatal growth retardation, and central nervous system structural and/or functional abnormalities.

Partial FAS, Alcohol Related Neurodevelopmental Disorder (ARND) and Alcohol Related Birth Defects (ARBD) are other diagnoses covered by FASD (Burd et al., 2007). Alcohol consumption is common in many cultures and consumption in young women has increased over the past thirty years, with an increasingly frequent pattern of risky drinking and increased risk of unintentional alcohol consumption during pregnancy. Up to 50% of pregnancies are unplanned and there is an association between binge drinking and unplanned conception. Consequently, there is potentially a high rate of fetal exposure to alcohol.

The prevalence is higher in women (6.8%) than in men (4.1%) [25]. The HIV prevalence varies by marital status: 3.5% among unmarried, 6.2% among married and 18.5% among formerly married (widowed or divorced) persons. The prevalence in monogamous and polygamous families is 6.6% and 5.5% respectively. To sustain a heterosexual HIV epidemic, an (infected) person must have unprotected sex with more than one partner.

The only way this can happen in marriage is through extramarital sexual relationships, given that polygamy is not a significant HIV risk factor in our setting. Since alcohol is the most common form of substance abuse in Cameroon and is associated with unsafe sexual behaviours in other societies as indicated above, it may be a common and potentially modifiable risk factor for HIV infection in the country.

In order to design effective health promotion strategies to reduce alcohol consumption in pregnancy, we need to understand potential influences on women’s behaviour. In this regard this study aims to ascertain women’s knowledge and Practices regarding alcohol consumption in pregnancy in the Tiko Community.

1.3 Hypothesis

Null: Pregnant women in the Tiko community do not have adequate knowledge and Practices in the consumption of alcohol in Pregnancy

Alternate: Pregnant women in the Tiko community have adequate knowledge and Practices in the consumption of alcohol in Pregnancy.

1.4 General Objective

To assess knowledge and Practices of pregnant women on the consumption of alcohol in the Tiko community.

1.5 Specific Objectives

1. To assess the knowledge of pregnant women in the consumption of alcohol in the Tiko community
2. To assess Practices of pregnant women on the consumption of alcohol in the Tiko community
3. To identify the causes of alcohol consumption in pregnancy in the Tiko community