ABSTRACT
Maternal death or maternal mortality is
defined by the World Health Organization (WHO, 1989) as the death of a woman
while pregnant or within 42 days of termination of pregnancy, irrespective of
the duration and site of the pregnancy, from any cause related to or aggravated
by the pregnancy or its management but not from accidental or incidental
causes, So, this research titled “investigating the consequences of poor
utilization of ANC Services among pregnant women of Kabak Community, the
research aims to a) to identify the effects of poor ANC attendance by pregnant
women in Kabak Community”, b) to identify the effects of poor ANC by pregnant
women in Kabak community, c) to investigate the prevalence of maternal
mortality within Kabak Community, the study adopted a descriptive research design,
and also questionnaire was used to collect information/data, after the questionnaires were
received from the respondents, they are coded with numbers and the responses
grouped into categories. In analyzing questionnaires, the SPSS software version
20 was used to perform statistical analysis, which include frequencies and
percentages. The researcher made use of tables, charts, and graphs to present,
organize, describe, and summaries raw data. The research has revealed that poor
utilization of antenatal care services significantly contributes to maternal
morbidity and mortality in Kabak Town. Even though a substantial number of
women are aware of the importance of ANC, actual regular attendance remains low
due to multiple socio-economic and cultural barriers. Based on the findings of
the study, the following recommendations were made: To the Government should
increase funding and support for maternal healthcare by making ANC services
entirely free and equipping primary health centers, the Health Workers should
conduct regular community sensitization programs on the importance of early and
consistent ANC attendance, the train traditional birth attendants (TBAs) to
refer complicated cases and collaborate with formal health systems, NGO’s
should also support outreach programs in hard-to-reach areas, focusing on
maternal health education and to collaborate with religious and community
leaders to address cultural and religious barriers to ANC attendance, and also
the community and families should encourage male involvement in maternal health
decision-making, especially in supporting their spouses to attend ANC.
TABLE OF CONTENT
Preliminary Pages
Title Page.............................................................................................................................. i
Declaration.......................................................................................................................... ii
Approval Page.................................................................................................................... iii
Dedication........................................................................................................................... iv
Acknowledgement............................................................................................................... v
Abstract............................................................................................................................... vi
Table of Contents.............................................................................................................. vii
CHAPTER ONE: INTRODUCTION................................................................................. 1
1.1 Background of the Study............................................................................................... 1
1.2 Statement of the Problem.............................................................................................. 2
1.3 Objectives of the Study................................................................................................. 3
1.4 Research Questions....................................................................................................... 3
1.5 Significance of the Study.............................................................................................. 4
1.6 Scope of the Study......................................................................................................... 4
1.7 Definition of Terms....................................................................................................... 5
CHAPTER TWO: LITERATURE REVIEW..................................................................... 7
2.0 Introduction................................................................................................................... 7
2.1 Conceptual Review........................................................................................................ 7
2.1.1 Maternal Mortality...................................................................................................... 7
2.1.2 Maternal Health.......................................................................................................... 9
2.1.3 Pregnancy and Pregnancy Period............................................................................. 10
2.1.4 Antenatal Care (ANC).............................................................................................. 10
2.1.5 Maternal Mortality – Causes and Prevention........................................................... 11
2.2 Empirical Review........................................................................................................ 12
2.3 Theoretical Framework............................................................................................... 14
2.4 Gap in Literature.......................................................................................................... 17
CHAPTER THREE: RESEARCH METHODOLOGY.................................................... 19
3.0 Introduction................................................................................................................. 19
3.1 Research Design.......................................................................................................... 19
3.2 Area/Population of the Study...................................................................................... 19
3.3 Sampling Techniques.................................................................................................. 20
3.4 Method of Data Collection.......................................................................................... 20
3.5 Method of Data Analysis............................................................................................. 20
3.6 Ethical Considerations................................................................................................. 21
CHAPTER FOUR: DATA PRESENTATION, ANALYSIS AND INTERPRETATION 22
4.0 Introduction................................................................................................................. 22
4.1 Socio-Demographic Characteristics............................................................................ 22
4.2 Antenatal Care Utilization........................................................................................... 23
4.3 Causes and Effects of Poor ANC Utilization.............................................................. 24
4.4 Knowledge and Perception on ANC........................................................................... 25
4.5 Discussion of Findings................................................................................................ 27
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS......... 29
5.0 Introduction................................................................................................................. 29
5.1 Summary of Findings.................................................................................................. 29
5.2 Conclusion................................................................................................................... 30
5.3 Recommendations....................................................................................................... 31
5.4 Suggestions for Further Studies................................................................................... 32
References......................................................................................................................... 33
Appendices........................................................................................................................ 35
Appendix I: Questionnaire................................................................................................ 36
CHAPTER ONE
INTRODUCTION
1.1 BACKROUND
OF THE STUDY
Maternal death or
maternal mortality is defined by the World Health Organization (WHO, 1989) as
"the death of a woman while pregnant or within 42 days of termination of
pregnancy, irrespective of the duration and site of the pregnancy, from any
cause related to or aggravated by the pregnancy or its management but not from
accidental or incidental causes."
The high rate of maternal and child mortality
in Nigeria has been a major cause of public health concern at both national and
international levels. In response to recommendations made by experts. And in
efforts to address this developmental challenge, Nigeria’s Federal Ministry of
Health (FMOH, 2013) approved that all maternal health institutions in the
country should periodically carry out maternal death review, surveillance and
response, using the technical guidance document as recommended by the WHO. This
was updated in 2016 to include Perinatal Death Reviews, while the initiative
was retitled Maternal and Perinatal Death Surveillance and Response (MPDSR), to
take account of the equally high rates of stillbirth, neonatal and perinatal
deaths in the country. Essentially, it is hoped that with regular reviews of
maternal and perinatal deaths, and an analysis of the causes of deaths, that
recommendations could be made that if addressed, would reduce the high rates of
maternal and perinatal mortality in the country. This approach was required to
address the current lack of substantive data on the circumstances under which
maternal and perinatal deaths occur in Nigeria, needed to design strategies, policies
and programs at a health systems level to reverse the trend.
Since its promulgation, the Federal Ministry
of Health has recommended that all States in the country adopt a uniform
protocol for conducting the reviews. The Lagos State Ministry of Health, one of
Nigeria’s 36 federating States, started implementing the recommendations and
protocol in 2014. This included an initial state-wide assessment of maternal
mortality rates which identified un-acceptably high rates in the most rural
Local Government Areas of the State. Thereafter, State officials constituted a committee
to review maternal deaths using the methods and protocols recommended by the
Federal Ministry of Health. The Committee was given the mandate to collate
accurate data and make recommendations on ways to reduce the rate of maternal
deaths in the State.
Our initial systematic analysis of maternal
death reviews in Nigeria suggests that substantial information can be obtained
through this process to strengthen health systems in efforts to reduce maternal
mortality rates. Since previous maternal death reviews were not systematically
carried out in many parts of the country, we sought to follow up reviews
conducted in three public hospitals in Lagos state in a prospective manner in
order to report the outcomes and the lessons learnt. In particular, as this
review added the element of surveillance and policy/programmatic feedback, we
sought to determine how this approach might impact on maternal mortality
prevention. We hypothesized that maternal mortality would decline if corrective
measures are taken to rectify the medical and social factors that are
identified in the reports as associated with maternal mortality. The objective
of this study therefore, is to report the results and outcomes of maternal
death reviews conducted in the hospitals over the initial two-year period. We
believe the results will be useful for improving the delivery of maternal death
reviews and surveillance, and eventually provide useful lessons for scaling up
the method throughout the country, (Lag, 2008)
1.2 STATEMENT
OF THE PROBLEM
Maternal and child
mortality has become a very serious problem which affects women and children in
the study area.
Although government provide services and
facilities for maternal and child health services, and also provide a
well-trained health worker for counseling and guiding mothers on how to take
care of themselves during pregnancy, and the importance of attending or
receiving maternal and child health care services during pregnancy or labor.
Government also distributes some drugs,
i.e., blood tonic, anti-malarial drugs, paracetamol to pregnant women free,
with all of the above attention of government to prevent maternal and child
mortality, still the problem occurs in the study area and most of the hospitals
and health facilities. This is due to the poor attitude, poor nutritional
status, and ignorance of mothers towards ante natal services, traditional
beliefs and poor enlightenment by the health workers. These are some of the
predisposing factors to maternal and child mortality in kirikasamma Local
Government Area, Jigawa State Nigeria.
1.3 OBJECTIVES
OF THE STUDY
Ø Main
objective:
·
To
identify the effects of poor ANC attendance by pregnant women in Kabak
Community, Kiri-kasamma Local Government Area, Jigawa State of Nigeria.
Ø Specific
Objectives:
1.
To
identify the effects of poor ANC by pregnant women in Kabak community
2.
To
investigate the prevalence of maternal mortality within Kabak Community.
3. To identify the factors hindering attendance
of ANC by pregnant women in Kabak Community
4. To identify possible solution to reduce and
control the rate of maternal mortality in Kabak Community
1.4 RESEACH
QUESTION
1. What are the effects of poor ANC attendance to
pregnant women?
2. What is the prevalence rate of ANC in Kabak
Community?
3. Are illiteracy, poor enlightenment,
traditional and cultural beliefs and poor attitude of women being predisposing
factors to maternal mortality?
4. Can maternal mortality occur due to poor
nutritional status of the pregnant women?
5. Can maternal mortality be prevented or reduce
through ante-natal consultation?
6. What will be the possible solution to reduce
the rate of maternal mortality in Kabak Kirikasamma Local Government Jigawa State?
1.5 SIGNIFICANCE
OF THE STUDY
This
research work is highly significant especially to the ministry of health that
is responsible for maternal and child health care services to the communities.
The research is also useful to Non-Governmental Organization like WHO and
UNICEF in promoting maternal and child health and prevention of maternal and
child mortality.
It is also significant to other researchers
having the same topic or similar interest in which they can expand their
assessments area and develop additional questions to provide wider
improvements. In addition, the research will be significant to the group of
pregnant women in the study area as it will serve as awareness creation and it
will save lives.
Furthermore, it will serve as a guide to
health promotion officers i.e. what models are used to solve the problem of
maternal and child mortality in any community
1.6 SCOPE
OF THE STUDY
This work should cover geographically the
Kabak Village, Kirikasamma Local Government Jigawa State Nigeria. The town is
in Kirikasamma LGA, this Local Government is bounded to the east by Guri local
Government Area, to west by Hadejia Local Govt Area to south by Zaki Local
Government Area to the North Birniwa Local Govt Area. Geographical coordinates
are 12⁰ 21⁰ 48⁰” North 9⁰ 34⁰ 56⁰ East.
The study also covers pregnant women which are
part of kirikasamma Local Govt in other to assess the prevalence of maternal
and child mortality rate.
1.7 DEFINITION
OF TERMS
- Maternal mortality: is the death of a
women while pregnant or within 42 days of terminating of the pregnancy
- Child mortality: is the death of infants
due to the complications of delivery or diseases
- Infants: child between 0-59 months of
age.
- Maternal Morbidity: sickness of a
pregnant women
- Abortion: the giving birth to an embryo fetus prior to the stage of
visibility at about 20 weeks of gestation before term
- Embolism: the condition in which there is
obstruction of blood vessels by the impaction of body
- Eclampsia: is an increase in high blood
pressure greater than 160/110 in pregnant women associated with
convulsion.
- Ante natal care: a consultation and care
advices given to pregnant women from the onset of pregnancy to the
delivery
- Assessments: - refers to the wide variety
of methods or tools that educators use to evaluate, measure, and document
the academic readiness, learning progress, skill acquisition, or
educational needs of students (Abbott (Ed.), 2014)
- Uptake: The process by which something is
taken in by the body (Merriam-Webster).
- Antimalarial: - Antimalarial drugs are
used for the treatment and prevention of malaria infection. Most
antimalarial drugs target the erythrocytic stage of malaria infection,
which is the phase of infection that causes symptomatic illness (Laufer,
2016).
- Pregnant women: - also known as gravidity or gestation
is the time during which one or more offspring develops inside a woman
(Dowswell, 2015).
- Kirikasamma;- Is a town and a local
Government Area in the north eastern Jigawa State, Nigeria some 120
kilometers south – east of Kano. As of 2007 the town of kirikasamma had an
estimated population of 27,000 the world Gazetteer”. (Holders, 2007).
- Knowledge: -facts, information, and
skills acquired through experience or education; the theoretical or
practical understanding of a subject: (oxford Dictionary)
- Utilization; - Is the primary method by
which asset performance is measured and success.
- Acceptance; - Is the act of taking or
receiving something offered: (oxford Dictionary)
- IPTp: Intermittent
preventive treatment for prevention of malaria in pregnancy (IPTp)
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