ANTENATAL UTILIZATION AMONG THE IDPS IN MAIDUGURI (CASE STUDY OF GWANGE)

CHAPTER ONE

INTRODUCTION

1.1   Background of the study

Nigeria has one of the highest numbers of displaced persons in Africa as at 2016 and accounts for about 15 million internally displaced by conflict and generalized violence (Bilak et al, 2016). The insurgency in northeastern part of the Nigeria has killed large number of people and destroying homes, leading to the exodus of millions of internally-displaced persons who have turned Maiduguri into a congested capital. There are over 1.5 million IDPs that are displaced from about 18 local government areas of Borno state who were forced to leave the comfort of their homes to take refuge in the state capital as IDPs (NEMA, 2013). Borno State is worst affected in the North eastern region of Nigeria by terrorist activities, hence it has the largest number of IDPs. There are about one million five hundred internally displaced persons in the state (Sidi, 2015).

Women and children constitute over 70% of the internally displaced populations; they have unique health needs and are also vulnerable to different health problems such as unsafe abortions, maternal morbidity and mortality(Norwegian Refugee Council, 2015). These IDPs face several challenges which include poor infrastructure, limited access to basic health services, sexual abuse as well as gender-based violence.There is usually disruption in health services in this situation, which results in low or inadequate prevention of common diseases, resulting from poor access to healthcare, leaving the women at a higher risk of maternal morbidity and mortality (Fagbamigbe & Idemudia, 2015).

Globally, women especially those of reproductive age group are the most vulnerable and “special risk” members of society. Available statistics shows that approximately one thousand women die every day from preventable causes related to pregnancy and childbirth (Adewoye, 2011). Pregnancy and childbirth and their consequences are still leading causes of death, diseases and disability among women of reproductive age in developing countries (WHO, 2009).

However, in a situation where a country is faced with internal displacement, health facilities are important in providing medical care to the displaced population either in the IDP camps, host communities, or in cities where IDPs are living together with people. In Borno state, Adebowale (2020) confirmed that there are adequate health facilities, appropriate stock of health workers, with competencies and skill-mix to match the health need of the population within the state. He also stated that both the federal and state government play a major role in handling the primary, secondary, and tertiary health facilities respectively. On the other side, WHO, (2018) maintained that the health care facilities in Maiduguri, Borno State were less accessed by the internally displaced persons (IDPs) living in the metropolis. It is against this background that this study investigates the antenatal care utilization by IDPs in Gwange ward, Maiduguri, Borno State.

1.2   Statement of the Problem

There are about one million five hundred internally displaced persons in Borno State (Sidi, 2015). The living condition of the IDPs is very poor, particularly in the metropolis. The main problems are unsafe, overcrowded accommodation, low tenure security and poor access to good quality water and sanitation (Adewoye, 2011). Also Internally Displaced Persons have poor economic stability and low asset ownership (WHO, 2018).

Since it has been documented that there are about 1.5 million IDPs in Maiduguri and 93 adequate health facilities with appropriate stock of health workers, with competencies and skill-mix to match the health need of the population within the state. Including the services provided by several humanitarian bodies, international organizations and aid agencies. It is expected that the internally displaced persons are receiving adequate healthcare services. Therefore, based on the above statements this study close the gap by assessing whether health care, particularly ante-natal care provided to IDPs are adequate enough or not; and whether there are other factors hindering these utilization of antenatal.

1.3   Objectives of the Study

The main objective of this study is to assess antenatal care utilization among Internally Displaced Persons (IDPs) in Gwange. While the specific objectives are to:

i.       examine the extent to which IDPs in Gwange have access to health centers for good utilization of antenatal care,

ii.     assess the factors hindering the utilization of antenatal care among IDPs in Gwange,

iii.  explore possible solutions to the factors responsible for poor utilization of antenatal care among IDPs in Gwange.

1.4   Research Questions

The research questions of this study are as follows:

i.       To what extent IDPs in Gwange have access to health centers for good utilization of antenatal care?

ii.     What are factors hindering the utilization of antenatal care among IDPs in Gwange?

iii.  What are the possible solutions to the factors responsible for poor utilization of antenatal care in Gwange?

1.5   Significance of the Study

Firstly, the study would serve as a material (secondary data) for researchers and students who want to conduct studies on this topic. Secondly, the study would provide data on antenatal utilization among Internally Displaced Persons (IDPs) in Maiduguri, Borno State. The findings of this study may also assist policy makers in their quest to design programme which aims at improving the lives and health conditions of IDPs in Borno State and all over Nigeria. 

1.6   Scope of the Study

This study is concerned with antenatal utilization among Internally Displaced Persons in Maiduguri. The participants of the study are the Internally Displaced Women in Gwange.

1.7   Operational Definition of Terms

Antenatal care: is a routine health control of presumed healthy pregnant women, in order to diagnose diseases or complicating obstetric conditions without symptoms, and to provide information about lifestyle, pregnancy and delivery.

Internally displaced persons (DPs): are people who are forced to leave their homes but they remain within their country’s borders.

Pregnancy: is the term used to describe the period in which a fetus (young human before birth) develop inside a woman’s womb. Pregnancy usually lasts about 40 weeks, or just over 9 months, as measured from the last menstrual period of delivery.

Utilization: utilization is the act of practical and effective use of something. This study is concerned with antenatal utilization.

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