THE ASSESSMENT OF KNOWLEDGE AND PRACTICE ON ANC AMONG PREGNANT TEENAGERS IN BUEA HEALTH DISTRICT

ABSTRACT

Background

Antenatal care refers to the care that is given to an expectant mother from the time that pregnancy is confirmed until the onset of labor. This care enables the promotion of a positive pregnancy outcome. The components of ANC include: risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion [5]. Recently in 2016, WHO recommends a minimum of eight ANC contacts during pregnancy.

Method

This study was a hospital base retrospective cross sectional study in the Buea health district. I undertook a retrospective cross sectional study of 384 pregnant teenagers to get their antenatal care knowledge and practice in BHD during the period of May 15 to June 20 2021   

Results

 Pregnant teenage girl had adequate knowledge on antenatal care (57.2%) and had good attitude on antenatal care (53.9%).

Conclusion

 Antenatal care practices increase with increase in knowledge and better understanding on antenatal care. This show a strong correlation (r2= 0.43, p-value =0.00) between knowledge and practices.

CHAPETR ONE

INTRODUCTION

1.1 BACKGROUND

Antenatal care refers to the care that is given to an expectant mother from the time that pregnancy is confirmed until the onset of labor. This care enables the promotion of a positive pregnancy outcome. The components of ANC include: risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion [5]. Recently in 2016, WHO recommends a minimum of eight ANC contacts during pregnancy. [1, 10] The World Health Organization (WHO) began promoting a new model of ANC for low-income countries, moving away from the traditional model, developed largely in the West. The updated model, based on ‘reduced but goal-orientated clinic visits is the so-called ‘focused’ ANC, consisting of (at least) four visits to a health facility during an uncomplicated pregnancy [7]. The main reasons for not undergoing and avoiding checkups in adolescent pregnancy are emotional crises, lack of self-esteem, neglect of the future newborn, worry for the future and depression, lower socioeconomic status, lower education level, husband with lower education level, life in rural areas, and not being exposed to mass media [2]. Some pregnant teenagers are reluctant to carry out prenatal care in the early trimester. The negative experience received during a health examination is the most memorable and hurtful experience. The negative experience comes from judgmental words and judgmental attitudes from health professionals. The hopes of adolescents in order to improve the quality of ANC services include health workers who are expected to be able to interact with patients well so that patients feel comfortable [3]. In Cameroon, 85% of pregnant women attended at least one ANC Studies has shown that the morbidity and mortality of pregnant woman who attend antenatal care is reduced compared to women who do not attend antenatal care [4]. Early initiation of antenatal care visits is an essential component of services to improving maternal and new born health. The Cameroonian Demographic and Health Survey conducted in 2011 indicated that only 34% of pregnant women start antenatal care in the first trimester [5]. Minimum ANC visit 4 times during pregnancy is divided into 3 periods. 1 time at less than 12 months of pregnancy, 1 time at 24-28 weeks gestation, and 2 times at 32 and 36 weeks’ gestation [1]. Based on data from USAID [2]. It shows that out of 28.3% of pregnant women in Indonesia, have their first ANC after 4 months or more.  An estimate of 70000 adolescent mothers die each year world wild because their bodies are not yet physically ready for motherhood and due to social disadvantages.  2015 reports estimates MMR in Cameroon at 596 maternal deaths per 100,000 live births. In 2015, countries met and put forward a series of goals known as sustainable development goals (SDGs). SDG 3 calls for the acceleration of current progress in order to achieve a global MMR of 70 maternal deaths per 100,000 live births in 2030.This global reduction of MMR and a positive pregnancy outcome can only be achieved if the care offered to women during pregnancy improve and they initiates antenatal care (ANC) early enough[5]

Most studies establish a cause-and-effect relationship between teenage pregnancy and inadequate antenatal care low birth weight, and preterm birth [10]. On the hand, such a relationship is less obvious in adverse pregnancy outcomes such as preeclampsia, cesarean delivery, vaginal instrumental delivery and postpartum hemorrhage. WHO reported that eight or more contacts for antenatal care can reduce perinatal deaths by up to 8 per 1000 births when compared to four visits [1]. 

1.2. PROBLEM STATEMENT

Although WHO recommends that every woman should start antenatal care before 12 weeks of pregnancy and should a minimum of eight ANC contacts during pregnancy, but many pregnant women go for their first ANC visit after 12 weeks of pregnancy and have less than eight antenatal contacts. In Cameroon, 85% of pregnant women attended at least one ANC.  Hence this study needed to be looked at to encourage good antenatal practices and early initiation of antenatal care visits are essential component of services to improving maternal and new born health

1.3. RESEARCH QUESTIONS

The research questions include;

1. What knowledge do pregnant teenagers have on antenatal care?

2. What is the practice of pregnant teenager towards antenatal care?

1.4. RESEARCH OBJECTIVE

The main objectives of the research is;

To assess the knowledge and practice of pregnant teenagers on antenatal care (ANC)  in the Buea Health District.

The specific objective include;

1. To assess the knowledge of pregnant teenagers on antenatal care in Buea Health District
2. To determine the antenatal care practices of a pregnant teenagers in Buea Health District

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