KNOWLEDGE AND PRACTICE OF PREGNANT ADOLESCENT GIRLS, 15-19YEARS ON ANTENATAL CARE IN BUEA HEALTH DISTRICT

Abstract

Appropriate antenatal care is one of the pillars of motherhood; a worldwide effort launched by the World Health Organization (WHO) and other collaborating agencies in 1987 aimed to reduce the number of deaths associated with pregnancy and children. Adolescent pregnancy constitutes a public health problem in Cameroon.

This work was undertaken to assess the knowledge and practices of pregnant adolescent girls on ANC in the Buea health district. One hundred adolescent pregnant girls living within the Buea health district were recruited into this study upon signing of an informed consent form. Information relating to demography, knowledge on ANC was captured using a structured questionnaire.

The information collected was analyzed using the SPSS version and presented in charts and tables. The results revealed that 78 % were single and level of education was as follows: primary school (5%), secondary school (48%), high school (41%), and university (6%).Participants ability to define antenatal care was as follows: good (9%),fair (52%) and bad ( 39%).

The mean level of knowledge on antenatal care was 54%.The proportion of  participants who attended  antenatal visits regularly  was 84%.Only 22% participants started attending  antenatal care  during the first semester  of pregnancy .The most notable  challenges toward antenatal  care  were lack of finances (50%) followed by lack of  time  (21%) and the least  challenges was failing to remember date for ANC  visits.

We concluded that adolescent pregnant girls within Buea health district do not have adequate knowledge on antenatal care. The proportion of  adolescent  girls  that begin  ANC during  the first trimester of pregnancy is low .The level of regular  attendance during ANC visits is  good but can be improved upon .The major challenges hindering the use antenatal  care  services are lack of finance and time.

CHAPTER ONE

INTRODUCTION

1.1 Background

Appropriate antenatal care is one of the pillar of safe mother hood initiatives ;a worldwide effort launched by the World Health organization  and other collaborating agencies in 1987 aimed to reduce the number of deaths associated with pregnancy and children. It highlights the care of antenatal mother as an important element in maternal healthcare as appropriate care will lead to successful pregnancy outcome and healthy babies (Nicholas, 2010).

All pregnant adolescent girls are expected to go for their antenatal checkup in the first trimester to identify and manage any medical complications as well as to screen them for any risk factors that may affect the progress and outcome of their pregnancy.

According  to Perinatal Care Manual recently edited by the Minister of Health Malaysia, primigravida women are advised to go for a total of ten visits during their pregnancy and for  multigravida women, the total recommended antenatal visits is seven sessions (MOHM,2010).

In different part of the world ,adolescents have been identified as the most vulnerable group in sexual reproductive health issues (Dick,2015).This makes adolescence, the time period between 11 and 19 years of age, the critical stage in life during which people undergo extensive biological, psychological and social changes (Dick and Ferguson,2015).

According to UNICEF (2015),about 22 million are at risk of becoming brides before they turn 18,although government have come up with policies on adolescent health, adolescent still have limited access to information and health services that will improve their health.

These concerns are particularly true for adolescents in developing countries who constitute approximately 70% of all adolescent pregnancy in the world (UN, 2012). In addition to inaccessible health information ,adolescent are faced with pregnancy-related complications, which research shows is the second leading cause of death among girls aged 15-19 in Sub-Saharan African (Fatusi and Hindin,2010).

Addressing the complications related adolescents pregnancies and deliveries, WHO and UNEPA developed guidelines on preventing early pregnancies and reducing poor reproductive outcomes. They recommend the need for increasing use of skilled antenatal and post natal care among adolescents (WHO, 2016).

Antenatal care is more important and beneficial in the prevention of adverse outcomes when it is sought early in the pregnancy. The WHO recommends that a woman without complications should have at least four antenatal care visits, the first of which should take place during the first trimester (GSS,2009).However ,research shows that pregnant  adolescents are less likely than older women to receive good ANC and skilled medical care at delivery(WHO,2006).

This disinterest has been speculated to be due to social factors such as culture, low literacy level, inadequate reproductive health knowledge and infrequent ANC attendance. These factors in one way or the other affect pregnant adolescents health seeking behaviors, which usually increases the chances of pregnancy related complications and poor pregnancy outcomes (Mattua,2011;Singh and Khare,2012;Ziyani et al;2011).

1.2 Problem Statement

In many research studies, low ANC compliance among adolescents has been noted (Phafoli et al 2010).where this occurs, a large number has also been noted to have late attendance, usually in the third trimester.

For instance , following a study done at Lesotho out of the 632 pregnant teenagers sampled 43% visited the antenatal clinic for the first time in their third trimester and only 14.9% attended in the first trimester,78% of the 14.9%who attended were married teenagers (Phafoli et al 2010).

It is also known that adolescence mothers have many complications and undesired outcomes .This is because they are children themselves and their bodies are not yet sufficiently developed to handle pregnancy and delivery.

It is expected that by attending antenatal clinic they would be equipped with health information on how to care for themselves during pregnancy, delivery and after (Phafoli et al).When many adolescents mothers do not attend clinic, their risky life situation which has been established to be worse than that of other expectant mothers keeps them in a highly compromised situation.

It is therefore necessary to established ways of making them adapt healthy antenatal health seeking behaviors giving me the reason to assess pregnant adolescents’ knowledge and practices on ANC.

1.3 Null Hypothesis

Pregnant adolescent girls in the Buea District Health area lack adequate knowledge and good practices on antenatal care

1.4 General Objectives 

Assessing the knowledge and practices of pregnant adolescent girls (15-19) years on antennal care in the Buea health district area

1.5 Specific Objectives

1. To find out the challenges faced by pregnant adolescent girls in the Buea Health district on antenatal care.
2. To find out if pregnant adolescent girls in the Buea Health district regularly attend antenatal care
3. To evaluate the practices of adolescent pregnant girls toward ANC.

1.6 Research Questions

1. What are the challenges faced by pregnant adolescent girls in the Buea Health district on antenatal care?
2. Do pregnant adolescent girls in the Buea Health district regularly attend antenatal care visits?
3. Pregnant adolescent girls in the Buea Health district have adequate knowledge on antenatal care?