ASSESSING THE KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARD ANTENATAL CARE AMONG PREGNANT WOMEN AT THE BUEA REGIONAL HOSPITAL
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Antenatal care is one of the strategies aimed at addressing maternal mortality as it facilitates the identification and avoid pregnancy related problems and save lives of mothers and babies. The aim of the study was to assess the knowledge attitude and practice towards antenatal care among pregnant women at the Buea Regional Hospital, during the period of the study from February 2023-March 2023. A cross sectional descriptive research design was used involving 100 pregnant women. Data analysis was done using Statistical Package for Social Science version 20 for analysis (SPSS).
The study involved a total of 100 respondents, of which 32% had adequate knowledge on antenatal care, with most of them getting ANC information from health care providers. Also 42% of the respondents believe a pregnant woman should make 7 to 8 visits. Looking at the attitude, 71% pregnant women believe ANC is necessary for all pregnant women.
In terms of practice towards ANC, 48% of pregnant women started ANC during the 4th and 5th months of the pregnancy; therefore most women initiated ANC later than the recommendations by the World Health Organization (WHO). The study also shows that 25% of pregnant women doing ANC at BRH do not carry their entire test while 21% don’t do all their echography.#
In conclusion, majority (68%) had inadequate knowledge, majority has positive attitude towards ANC but poor antenatal care practice. Health authorities should intensify national health education programmes aimed at helping pregnant women start ANC early and understand the need to do all ANC test recommended.
1.1 Background of Study
The experience of pregnancy and childbirth has proved to be a major risk for women, a risk that is filled with suffering and even results in death for thousands of women worldwide. The United Nations Children’s Fund (UNICEF) estimates that every year more than 295,000 women die of problems that are related to pregnancy and childbirth (UNICEF, 2017).
Most of these deaths were concentrated in developing countries, mostly sub-Saharan Africa and Asia, with sub-Saharan Africa contributing to 87% of such deaths globally, as reported by the United Nations (UN, 2018). The major causes of maternal mortality in the developing regions are hemorrhage and hypertension, which contribute to half of all deaths in expectant and new mothers (UN, 2017). Most of the deaths can be prevented or managed through the correct interventions by skilled healthcare providers and by using the correct equipment (UN, 2017)
Antenatal care is a medical and general care that is provided to pregnant women during pregnancy and includes education, counseling, screening and treatment to monitor and to promote the well-being of the mother and fetus (Adewoye, 2013).
Antenatal Care is an opportunity to addresses risk, promote health, and provide care and counsel women about the benefits of child spacing (Rashid & Junichi, 2015). Antenatal care may take place in hospital, health center or clinic by health professionals, the aim is to ensure that the mother reach the end of pregnancy as healthy as, or even healthier than she was before (World Health Organisation, 2014).
Maternal mortality is one of the major concerns of the United Nations (UN) as indicated by the adoption of the United Nations Millennium Declaration in 2000, when member states agreed to assist one another in helping citizens of poor countries to have a better life (UN, 2017). The 5th Millennium Development Goals focuses on improving maternal mortality. The cornerstone of maternal and perinatal healthcare has been identified as ANC and it will facilitate the achievement of MDG 5 (Kader, 2018).
According to the United Nations Millennium Development Goals, every year hundreds of women and girls die as a result of complications during pregnancy, childbirth or the six weeks following delivery. Almost all (87%) of these deaths occur in developing countries. This shows that the Antenatal care activity is very weak in developing countries.
The main reasons that hinder the use of antenatal care are different from country to country. Developing countries encounter hemorrhage, followed by eclampsia, infection, abortion complications and obstructed labor. Other issues are lack of knowledge and preparedness about reproductive health in the family, community and health provider (Ojo, 2014).
To alleviate high maternal mortality, Antenatal Care is the most important method for detecting pregnancy problems in the early period. Because antenatal care is the best mechanism to minimize maternal mortality and give a piece of good information for pregnant women about their birth and how to prevent related problems.
The best and most advantage of Antenatal Care is to protect the health of women’s and their infants as well as indicating the danger signals that will be occurred and needs to be further treated by advanced health professionals (Effendi, 2018).
Cameroon has seen a drop in maternal mortality with 782 deaths / 100,000 lives born occurring in 2011 to 406 deaths / 100,000 lives born occurring in 2018, given a 48% reduction in maternal mortality between 2011 and 2018 (International Committee for Functional disability, 2018).
Cameroon has adopted most of the international treaties, initiatives and programmes related to maternal and child health (UNFPA, 2018). In its commitment to ensuring that all pregnant women had access to care, especially poor women, Cameroon government under the patronage of the first Lady Mrs Chantal Biya launched its National Multi Sectoral Programme to reduce maternal and child modality by 25% in the period of 5 years.
The Cameroon government has a national target of 140 deaths per 100,000 live born in 2030 (UNFPA, 2016).
Most maternal deaths in Cameroon are preventable, as the healthcare solutions to prevent and manage complications are well known. Most of these preventable deaths during pregnancy and child birth have been attributed to poor utilization of antenatal care services (ANC). Antenatal care is considered as of the safe motherhood interventions (Hitimana, 2018).
All women need to access to ANC in pregnancy, skilled care during childbirth and care and support after childbirth. This is in respect to the fact that ANC can serve as a platform for the delivery of highly effective health intervention that can reduce preventable maternal and newborn deaths (Dejong, 2016).
However for ANC to be effective in preventing adverse pregnancy outcomes, it should be sought early in pregnancy and should continue all through the delivery. When ANC is not properly implemented, it can miss certain danger signs or delay referral to emergency obstetrical care service, therefore contributing to maternal mortality (Manzi, 2018).
1.2 Problem Statements
Every day, approximately 800 women dies from preventable causes related to pregnancy and childbirth. This is about one woman every two minutes. Antenatal care is one of the means to reduce maternal mortality and morbidity with interventions and information that promote the health, wellbeing and survival of mothers and their babies (UN 2012).
WHO recommends that every woman should start antenatal care before 12 weeks of pregnancy and should have a minimum of 8 ANC contacts during pregnancy. But many pregnant women in Cameroon go for their first ANC visit after 12 weeks of pregnancy and have less than 8 antenatal contacts.
Although ANC services are highly accessible in Cameroon. The government has built hospitals in all Urban and Rural area to bring health services closer to the people. There are private hospitals and health centers, in all towns and some villages, making majority women to have access to ANC services, but most women still initiate ANC late.
According to national statistics, the proportion of women who initiate ANC during the recommended guidelines (within the first 12 weeks of pregnancy) is still low (UNFPA, 2018). It is against this background that the researcher decided to evaluate the knowledge attitude and practice of antenatal care among pregnant women in Buea regional hospital. .
1.3 Research Questions