Pregnancy Duration and Choice of Ante-natal and Delivery Care
CHAPTER ONE
Objective of the Study
The main objective of this study was to determine the pregnancy duration and choice of ante-natal and delivery care in Ijebu South while the specific objectives were to:
- To determine the perception of pregnant women towards the quality of antenatal care services in Ijebu South
- To examine providers’ processes of care in delivering antenatal services in Ijebu South.
- To determine the level of client satisfaction with antenatal services provided in Ijebu South.
CHAPTER TWO
LITERATURE REVIEW
This chapter of study deals with the review of relevant literature, studies and researches previously done that is related to this study. It will be carried out under the following headings:
- Conceptual Review
- Theoretical Framework
- Empirical Review
- Summary of the Review
Conceptual Review
Antenatal Care
Antenatal care according to Adesokan (2014) refers to the attention, education, supervision and treatment given to the pregnant mother from the time conception is confirmed until the beginning of labour in order to ensure safe pregnancy, labour and puerperium. It is also known as prenatal care which is a type of preventive health care with a goal of providing regular checkups that allow doctors or midwives to treat and prevent potential health problems throughout the course of pregnancy while promoting health lifestyles that benefit both mother and child.During checkups, pregnant women will receive medical information over maternal physiological changes in pregnancy, biological changes and antenatal nutrition including antenatal vitamins (Adesokan, 2014).
Recommendations on management and healthy lifestyle changes are also made during regular checkups. The availability of routine antenatal care has played a part in reducing maternal death rates and miscarriages as well as birth defects, low birth weight, neonatal infections and other persuadable health problems. The World Health Organization (WHO) reported that in 2015, around 830 women died everyday from problems in pregnancy and childbirth. Only 5 of the women who died lived in high income countries, the vast of the women lived in high income countries. The WHO recommends that pregnant women should all receive four antenatal visits to spot and treat problems and give immunizations. Although antenatal care is important for improving the health of the mother and baby, many women do not receive four visits.
There are many ways changing health systems to help people change their behavior can also play a part. Examples of these interventions are: media campaigns reaching many people, enabling communities to take control of their own health, informative education, communication interventions or financial incentives. A review looking at these interventions found that one intervention helps improve the number of women receiving antenatal care.However, interventions used together may reduce babies death in pregnancy and early life, lower numbers of low birth weight babies born and improve numbers of women receiving antenatal care.
CHAPTER THREE
RESEARCH METHODOLOGY
This section of the study shows a thoughtful and systemic estimation of the specific method with which necessary data relating to the research problem is collected and analyzed. It provides the procedural framework for the conduct of the study and helps to describe the scope of the research as well as the purpose and boundary of the study. It is discussed under the following:
- Research Design
- Area of Study
- Target Population
- Sample and Sampling Technique
- Instrument for Data Collection
- Validity of Instrument
- Reliability of Instrument Data
- Method of Data Collection and Analysis
- Ethical Consideration
Research Design
Research design is a plan of action regarding events, which upon implementation enables the researcher adopt the survey design in carrying out the study. Ejifugha (2008) states that a survey is an attempt to gather information or data from members of a population with regard to one or more variables. The research design adopted for this study is the descriptive survey method. It deals with the factual description of perception and satisfaction with quality of antenatal care among pregnant women in NAUTH, Ijebu South.
CHAPTER FOUR
DATA ANALYSIS
This chapter discussed the finding and results as shown from the data analysis. This data was analyzed in accordance with the research questions using frequency distribution tables presented in percentages. One hundred and twenty questionnaires were distributed and same collected.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
Summary of Findings
Findings from this study showed good quality with regards to process of care and very good quality with regards to structural and outcome attribute of quality. There was a high level of client satisfaction with antenatal care received (86.8%). A significant association was observed between client satisfaction and marital status, educational level and occupational group (P<0.05) but no association was observed with parity (P>0.05). The gap in health worker’s availability in health facilities for antenatal care seems to be a recurring issue as many studies reported same. This is an issue that need to be addressed especially in the area of training to expand workers’ capacity. Regular in-service training comes highly recommended, supervision and various form of motivation to boost the productivity of the available workers. The observation of processes of care revealed poor practice of the minimum procedures to be done in antenatal consultations. A very important aspect of quality is client satisfaction with service provision and there are many determinants to that. This study has an overall clients’ satisfaction of 86.8% with 84.8% and 83.7% of the clients admitting willingness to come back in subsequent pregnancies and recommend the facility to someone else respectively. Many respondents had to wait for longer than one hour before being attended to but it is worth noting that the time they responded that they wait includes the time usually devoted to group health talk.
The importance of high quality antenatal care cannot be overemphasized at it will not only ensure women attendance to the clinics but will also contribute in combating maternal mortality which is high in this part of the world. Clients’ perspective of quality of care with regards to their satisfaction with service provision is also a vital part that should always be considered to have an improved service delivery.
Conclusion
The main objective of this study was to determine the pregnancy duration and choice of ante-natal and delivery care in Ijebu South.
There is no doubt that the antenatal care services provided in the hospital is very good despite some observed shortcomings. Lack of enough manpower is a very big challenge to providing adequate antenatal service especially the lower cadre of staff. This is very important as everybody has a role to play at different stages in accessing care.
Recommendation
The following recommendations were made based on the findings of the study;
- There should be a periodic assessment of quality of antenatal care as this will help for continuous improvement in service delivery especially looking at quality from the clients’ perspectives.
- The authority should employ workers in the primary health centres especially the lower cadre of staff that provide allied services in the centre like personnel, pharmacy technician etc.
- There should be regular supervision and in-service training for the staff to keep them abreast with recent development on best practices in patient care with regards to things like client privacy, health education etc.
- There should be awareness creation on the part of the service providers on the need to reduce client waiting time as it is a major cause of dissatisfaction and also on the part of the government to employ more staff to meet the required minimum standard so as to reduce provider-client ratio.
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