Perception of Quality and Satisfaction With ANC Services Among Pregnant Women Attending ANC Clinic at Noh Dala-kano
CHAPTER ONE
Research Objectives
- To examine the factors associated with the use of prenatal care at public health facility in Dala-Kano Local Government Area by mothers
- To determine the level of mothers ‘ perception of the services available in terms of quality and knowledge, and their satisfaction level with the provided antenatal services
- To provide a better understanding of the determinants of antenatal care utilization by mothers in Dala-Kano Local Government Area
- To contribute to an understanding of the needed interventions for improving antenatal care utilization in Nigeria
CHAPTER TWO
LITERATURE REVIEW
Introduction
First of all, the two aspects of health services are introduced in this chapter: delivery and utilization, and briefly explained.
Health services: Delivery and Utilization
This section includes two subsections, healthcare delivery and utilization.
Health service delivery
Fortifying healthcare delivery is vital to reach the Millennium Development Goals (MDGs) associated with health which intends to minimize child death, maternal death and the encumbrance of communicable diseases. Providing healthcare service is a direct product of the healthcare system ensuing by means of assorted inputs, for instance, the health work force, supplies and procurement, and funding. Such inputs are increased to boost distribution and accessibility to the services. For the healthcare even with a least quality, guaranteeing their availability as well as accessibility are the fundamental tasks of a healthcare system (WHO, 2010).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter covers research design, study area, population study, sampling and sampling procedures, research tools, data collection procedures, data processing techniques, ethical considerations, and variables operational definition.
Research design
In a public hospital in Dala-Kano Local Government Area, a cross-sectional research was carried out to investigate the use of prenatal care among mothers. A case study design was used to unfold the exact situation as it was within the public health facility during the time of study. Kothari (2004) stated that a case study method is a widely used systematic field research technique in social science, with a complete observation of a social unit in details to obtain enough information for drawing correct inferences.
A mixed-method (both quantitative and qualitative) data collection technique was applied in this study. Prior review of medical records covering at least previous 12 months related to maternal and child healthcare documented in public health centers was done in September 2023. Based on the secondary data received from the medical records, a material for primary data collection (questionnaire) was prepared including questions for information about women’s knowledge, perception, and satisfaction on antenatal care. This research approach was selected to study the utilization status of antenatal care among pregnant mothers and the factors associated with their utilization and their experiences in quantitatively and qualitatively. Pregnant women in the age of 15-49 in their third trimester attending antenatal care with at least 3 visits in the selected public hospital are recruited as respondents. Stratified sampling was used to reach the required sample size of study participants. This study exercised retrospective study approach as women’s experiences in their previous antenatal care contacts are reflected and investigated. Descriptive statistics with frequency distribution, chi-square tests were carried out with 95% confidence interval and significance of 5% level.
CHAPTER FOUR
RESULTS
INTRODUCTION
The previous chapter focused on the research methodology which encompassed research design, the study site, the study population, sampling, data collection, data analysis, validity, reliability, inclusion and exclusion criteria, and ethical considerations. This chapter deals with the data analysis based on the responses on the completed questionnaires on knowledge of and perception about antenatal services among pregnant women in NOH Dala-Kano in Kano State. Data analysis was done using IBM SPSS version 23. The results are presented as frequencies and percentages in tables, charts and graphs. Chi-square tests were done to determine associations between variables.
CHAPTER FIVE
DISCUSSION OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
DISCUSSION OF FINDINGS
The interpretation of the findings in this section is outlined according to the objectives of the study. All the objectives of the study were achieved.
Socio-demographic profile of the respondents
A total of 393 respondents participated in the study. The results show that most of the respondents were at age group 24-28 yrs. Age has been found to be a significant factor influencing the utilization of antenatal services. For example, in a study conducted in Nigeria, it was found that women aged 21- 30 were more likely to utilized ANC services (Odetola 2015) In a study conducted in Ethiopia, maternal age was found to be a factor in the utilization of ANC services (Abose, Woldie & Ololo 2010). This study revealed that women in the age group of 25-29 years were less likely to utilize ANC services compared to those women 35 years of age and older (Abose et al. 2010). This was supported by a study conducted in Nigeria where 96,5% of women aged 20-29 were found utilise ANC services properly as compared to women in other age groups (Akanbiemu, Manuwa-Olumide, Fagbamigbe & Adebowale 2013). The majority of respondents had secondary education, followed by those who had gone to a tertiary institution. Education has been found to influence knowledge and pregnant women with good education are expected to know the importance of utilizing antenatal services. This study was supported by a study conducted in a rural area of India which revealed that pregnant women in that area had good knowledge of ANC among the educated when compared to those who were illiterate. Maternal literacy remains a key factor in the utilization of ANC services (Gupta, Shora, Verma & Jan 2015).
5.1 Conclusion
The results show that pregnant women have adequate knowledge regarding ANC services, at 86, 0%.Perceptions about ANC services is average, at 50 4% and about 49,6% of the participants has a poor perception of the ANC service, although they indicated good perceptions of staff behaviour, at 76,8%. The respondents were not confident of the skills of staff, at 48, 8% .Their response revealed that staff skills were inefficient and that the booking process was complicated. However, with respect to the source of information, although the health centre scored 68, 2%, findings shows that there was little involvement of community members and the media. Findings also reveal that there was no association between educational level of respondents and their knowledge of ANC services. From the findings, it is apparent that pregnant women in NOH Dala-Kano have sufficient knowledge regarding ANC services; however, they have poor perceptions of ANC services. Therefore, there is a need to improve staff skills, access to ANC services and the link between the community and media.
Recommendations
Antenatal services are of great importance to further reduce maternal and neonatal deaths as most of these deaths are avoidable.
Practice
The booking process needs to be simplified to accommodate the individual needs of pregnant women. Policy makers should implement changes by strengthening the health care delivery system, taking into consideration the end care user of ANC services. Health information with regard to the importance of early ANC initiation and frequency of ANC visits needs to be intensified. Health information dissemination should also involve partners and family members to ensure support and encouragement to utilize ANC services properly. Communication between pregnant women and health workers at ANC clinics need to be strengthened. Media information exposure also needs to be strengthened by involving the radio, television and the use of billboards.
Education
It is recommended that the Department of Health strengthen the training programme of staff by providing further training exposure. There is a need for midwives to gain skills in establishing mutual relationship with pregnant women to ensure maximum utilization of ANC services.
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