Investigation into the Determinants of Adequate and Appropriate Quality Antenatal Care Among Nursing Mothers at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
Abstract
Background: Despite major advancements in healthcare, approximately 830 women die daily due to pregnancy-related complications, with the majority of these deaths occurring in developing countries. Antenatal care (ANC) is critical in preventing such complications by providing comprehensive health services to pregnant women. Adequate and appropriate ANC is vital for reducing maternal mortality and ensuring maternal and fetal health.
Objective: This study aimed to assess the determinants of adequate and appropriate quality antenatal care among nursing mothers attending Olabisi Onabanjo University Teaching Hospital in Sagamu, Ogun State, Nigeria. The focus was on understanding factors influencing knowledge, perception, and utilization of ANC services.
Method: A cross-sectional descriptive study was conducted at Olabisi Onabanjo University Teaching Hospital, formerly Ogun State University Teaching Hospital. The study included women of reproductive age attending the antenatal clinic. A systematic random sampling technique was used to select participants, who were given questionnaires to assess their knowledge, perception, and determinants of ANC. Data were analyzed using descriptive and inferential statistics with SPSS version 23.
Findings: The majority of respondents (87.4%) demonstrated good knowledge of ANC, although there was a gap in awareness regarding the frequency of visits. A positive perception of ANC was found in 81.8% of respondents. Key determinants influencing ANC utilization included family income, socio-cultural expectations, the influence of significant others, and the availability of quality healthcare workers. Most respondents recognized the benefits of ANC and were motivated by their health status and the desire to improve their child’s health.
Conclusion: The study concluded that while the majority of respondents had good knowledge and a positive perception of ANC, there were areas needing improvement, such as education about visit frequency and addressing variations in care perceptions. The availability of quality healthcare services and socio-cultural influences were significant factors in ANC utilization.
Recommendation: Enhance antenatal care services by increasing educational efforts, improving healthcare delivery, and addressing socio-economic barriers to ensure better maternal health outcomes
References
N. Yabo, M. A. Gebremicheal, and E. E. Chaka, “Assessment of quality of antenatal care (ANC) service provision among pregnant women in Ambo town public health institution, Ambo, Ethiopia, 2013,” American Journal of Nursing Science, vol. 4, no. 3, pp. 57–62, 2015.
Abou-Zahr I, Lidia C, Wardlaw TM., (2019). Antenatal Care in Developing Countries Promises, achievements and missed opportunities An Analysis of trends, levels and differentials, 2000–2019. Geneva: WHO.
Ademuyiwa IY, Opeke RO, Farotimi AA, Ejidokun A, Olowe AO, Ojo EA., (2021). Awareness and satisfaction with antenatal care services among pregnant women in Lagos state, Nigeria. Calabar J Health Sc; 5(1):21-7.
Ahmed, H., & Manzoor, I. (2019). Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore. Pakistan journal of medical sciences, 35(5), 1344–1348. Available at https://doi.org/10.12669/pjms.35.5.1256. Accessed on 2/8/21.
Akhtar, S., Hussain, M., Majeed, I., and Afzal, M., (2018). Knowledge Attitude and Practice Regarding Antenatal Care among Pregnant Women in Rural Area of Lahore. Int. J. Soc. Sc. Manage. Vol. 5, Issue-3: 155-162. Available at DOI: 10.3126/ijssm.v5i3.20604. Accessed on 2/8/21.
Awusi V, Anyanwu E, and Okeleke V., (2019). Determinants of antenatal care services utilization in Emevor Village, Nigeria. Benin J Postgrad Med; 11(1).
Berehe, T., Modibia, L., (2020). Assessment of Quality of Antenatal Care Services and Its Determinant Factors in Public Health Facilities of Hossana Town, Hadiya Zone, Southern Ethiopia: A Longitudinal Study, Advances in Public Health, Article ID 5436324, 11 pages. Available at https://doi.org/10.1155/2020/5436324. Accessed on 2/8/21.
Bergsjo P and Villar J., (2019). Scientrfic basis for the content of routine antenatal care. Acta Obstetricia et Gynecologica Scandinavica; 76: 1–14
Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gülmezoglu M, Mugford M, (2019). WHO systematic review of randomised controlled trials of routine antenatal care. Lancet; 357: 1565–70.
Ekabua J, Ekabua K, Njoku C., (2019). Proposed framework for making focussed antenatal care services accessible: A review of the Nigerian setting. ISRN Obstetrics and Gynecology.
Fagbamigbe AF, Idemudia ES., (2020). Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming. BMC pregnancy and childbirth; 15(1):95.
G. Fesseha, M. Alemayehu, B. Etana, K. Haileslassie, and A. Zemene, “Perceived quality of antenatal care service by pregnant women in public and private health facilities in Northern Ethiopia,” American Journal of Health Research, vol. 2, no. 4, pp. 146–151, 2014.
Gunawardena N, Bishwajit G, Yaya S., (2019). Facility-Based maternal death in Western Africa: a systematic review. Frontiers in public health; 6:48. pmid:29535999.
Kihara AB, Harries AD, Bissell K, Kizito W, Van Den Berg R, Mueke S, (2018). Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya 2010–2018. Public Health Action; 5(1):23–29.
Konlan, K., Saah, J., Amoah, R., Doat, A., Mohammed, D., & Abdulai, J., (2020). Factors influencing the utilization of Focused antenatal care services during pregnancy, a study among postnatal women in a tertiary healthcare facility, Ghana. Nursing Open; Volume 7, Issue 6 p. 1822-1832.
Kuhnt J, and Vollmer S., (2019). Antenatal care services and its implications for vital and health outcomes of children: evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open; 7:17122.
Lincetto, O., Mothebesoane-Anoh, S., Gomez, P., and Munjanja, S., (2020). Antenatal care. Opportunities for Africa’s Newborns. Available at https://www.who.int/pmnch/media/publications/aonsectionIII_2.pdf. Accessed on 10/11/21
M. Tetui, E. K. Ekirapa, J. Bua et al., “Quality of Antenatal care services in eastern Uganda: implications for interventions,” Pan African Medical Journal, vol. 13, no. 27, pp. 1–15, 2012.
Majoko F, Munjanja SP, Nystrom L, Mason E, Lindmwak G., (2017). Randomised controlled trial of two antenatal care models in rural Zimbabwe. BJOG; 114: 802–811.
N. Mekonnen, T. M. Berheto, S. Ololo, and F. Tafese, “Under nutrition and its association with infant and young child feeding summary index among 6 to 23 Months in demba Gofa
Woreda, southern Ethiopia,” Journal of Nutritional Health & Food Science, vol. 5, no. 3:502, pp. 1–15, 2017.
Okunlola M, Owonikoko K, Fawole A., (2018). Gestational age at antenatal booking and delivery outcome. Afr J Med Med Sci; 37(2):165–9.
Onyeajam, D. J., Xirasagar, S., Khan, M. M., Hardin, J. W., & Odutolu, O., (2018). Antenatal care satisfaction in a developing country: a cross-sectional study from Nigeria. Public Health 18:368.
P. Bastola, D. K. Yadav, and H. Gautam, “Quality of antenatal care services in selected health facilities of Kaski district, Nepal,” International Journal of Community Medicine and Public Health, vol. 5, no. 6, pp. 2182–2189, 2018.
Paudel, Y., Jha, T., and Mehata, (2017). Timing of First Antenatal Care (ANC) and Inequalities in Early Initiation of ANC in Nepal. Front. Public Health.
S. G., “Quality of antenatal care services at subcentres: an infrastructure, process and outcome evaluation in a district in Tamil Nadu,” International Journal of Community Medicine and Public Health, vol. 4, no. 11, pp. 4071–4077, 2017.
S. Mehnaz, S. Abedi, Z. Fazli, M. Ansari, Mohammed, and A. Ansari, “Quality of care: predictor for utilization of ANC services in slums of Aligarh,” International Journal of Medical Science and Public Health, vol. 5, no. 9, pp. 1869–1873, 2016.
Villar J, Ba'aqeel H, Piaggio G, Lumbiganon P, Miguel Belizán J, and Farnot U, (2018). WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet. 2001;357: 1551–1564.
Warri, D., George, A., (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: a qualitative interview study. BMC Pregnancy Childbirth 20, 70.
WHO, (2020). Trends in Maternal Mortality 2000 to 2019. Cited on 12th November 2021. Available on https://data.unicef.org/wp-content/uploads/2015/12/MMR_executive_summary_final_mid-res_243.pdf. Accessed on 2/8/21.
World Health Organization (WHO), (2019). WHO recommendations on antenatal care for positive pregnant experience. (Online). Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed on 2/8/21
Y. E. Housni, A. Khadmaoui, A. Kharbach, and E. Boussalwa, “Qual European journal of scientific researchity of antenatal care services in Morocco: case of the women delivering,” At Souissi Maternity, vol. 147, no. 4, pp. 426–432, 2017.
