Pattern of utilization of ante-natal and delivery services in a semi-urban community of North-Central Nigeria

Abimbola, Jimoh Maryam; Makanjuola, Akande Tanimola; Ganiyu, Salaudeen Adekunle; Babatunde, Uthman Mohammed Mubashir; Adekunle, Durowade Kabir; Olatayo, Aremu Ayodele

doi:10.4314/ahs.v16i4.12

Cited by 25 publications

(44 citation statements)

References 13 publications

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“…This finding is in agreement with other studies done in Africa [27,28]. Messages could be well designed to focus on the impact of the disease on the infant, to increase likelihood of vaccination [29,30].…”

Section: Discussionsupporting

confidence: 92%

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Kajungu

Stark²,

Weibel³

et al. 2020

PLoS ONE

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Background Maternal immunization is a successful and cost-effective public health strategy. It protects pregnant women and their infants from vaccine-preventable diseases. Uganda is exploring new vaccines for pregnant women like replacing Tetanus Toxoid (TT) with Tetanus-Diphtheria (Td). Research on knowledge, attitudes, beliefs, and willingness among pregnant women is needed before the introduction of vaccines for pregnant women. This study was aimed at exploring maternal knowledge, attitudes, willingness, and beliefs towards maternal immunization among pregnant women in rural Uganda. Methods This was a qualitative descriptive study. Ten focus group discussions (FGDs) were conducted at antenatal care (ANC) clinics and in a rural community of Uganda. Five key informant interviews (KIIs) were done with health workers, for triangulation. Considering context and research characteristics, data were collected and thematically analyzed. Results Women were familiar with the importance of maternal vaccines, had positive attitudes, and expressed willingness to take them. Acceptance of a new vaccine could be affected by worries of pregnant women and that of their partners, who influence health seeking decisions in a home concerning adverse events, following the maternal immunization (AEFI). There were misconceptions about introduction of vaccines such as the belief that vaccines treat malaria and general body weakness, and being used as guinea pigs to test for the vaccine before its introduction to the larger population. Conclusion A range of diverse sentiments and beliefs may affect uptake and acceptability of vaccines that are introduced in communities. For instance, ignoring vaccine safety concerns may impede maternal immunization acceptability, because pregnant women and their husbands are concerned about AEFI. Moreover, husbands make all health-seeking decisions at home, and their opinion is key, when considering such interventions.

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Section: Discussionsupporting

confidence: 92%

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Kajungu

Stark²,

Weibel³

et al. 2020

PLoS ONE

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“…We found that some women do not start ANC early because they demand new clothes from their husbands. This was also reported in other studies done in South Africa and Nigeria where women were reported to start ANC late because they needed to find money for transport and new clothes [ 19 , 20 ]. The finding of the studies shows that socio-economic status may be associated with the decision to seek health services especially on time to start ANC.…”

Section: Discussionsupporting

confidence: 74%

Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi

Chimatiro

Hajison²,

Chipeta

et al. 2018

Reprod Health

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BackgroundExploring barriers contributing to low utilization of Antenatal Care (ANC) during the first trimester of pregnancy is of national programmatic importance. We conducted an exploratory study in 2013 at Bilira Health Centre in Ntcheu district-Malawi with an aim of understanding barriers that prevent pregnant women from attending antenatal clinics in the first trimester of pregnancy.MethodThis was cross sectional exploratory study using qualitative approach. Data were collected from ANC clients, key informants, health services professionals and women of child bearing age (15–49 years) using an in-depth interviews and Focus Group Discussions (FGDs). Data were analysed manually by reading the transcriptions and memos several times inorder to be familiar with the themes emerged. The emerged themes were coded.ResultsMost of the women reported that they have a feeling of starting ANC in the early days of their pregnancies, however, they also reported several barriers ranging from cultural beliefs, social economic to service delivery barriers. On cultural barriers many women wait for marriage counselors from husband’s side to give them advice before starting ANC in the process called “Kuthimba”. Some women hide the pregnancy in early months to avoid being bewitched. On social-economic barriers, some of the women mentioned that they don’t start ANC early waiting for new clothes. Poor attitude of health workers also has an effect on ANC attendants. Most women pointed out that they started ANC late because some health workers were rude and do not observe confidentiality. Men’s refusal to accompany their spouses to antenatal clinic in fear of HIV test and some by-laws which restrict women who had pregnancy outside marriage to seek an authorisation letter first from Traditional Leaders for them to start ANC at the health facility were also mentioned as contributing barriers.ConclusionWomen should be oriented on the national guidelines on Focused ANC (FANC) which advocates for at least 4 visits. There should also be Information, Education and Communication (IEC) on ANC and interventions to deal with social-cultural issues while at the same time improving service delivery at the health facility so that ANC services can be accessible and responsive enough.

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“…[41] "I cannot go to the health facility for care during pregnancy because am not sick". [42 P.969] "Some people believe is only God that can help to deliver and so prefer to stay back at home for delivery, besides it is very comfortable and at no cost" [42] "Yes, attending for ANC is important but you only go there to deliver if you become weak or cannot deliver on your own without assistance . .…”

Section: Data Extraction and Meta-synthesismentioning

confidence: 99%

“…. One goes there only if a problem develops or when the labour takes much time" [39] "Some women prefer traditional home because if there is difficulty during delivery, spiritual intervention can be obtained" [42] "Allah (God) has now brought succor in ANC. Labor is now short, quick and uncomplicated.…”

Section: Data Extraction and Meta-synthesismentioning

confidence: 99%

“…[43] Theme four: Cultural barriers. Some quotes from the women include:"If there is no approval from husband, we would not go to seek care" [42] "A lot of women rely on their husbands and/or mothers-in-law for decision-making ..." "... many women are housewives. "There is one in my area ... she is pregnant ... in fact she is supposed to be here today, the man doesn't give her money for food, does not even take care of her and all that ... You know it is frustrating".…”

Section: Data Extraction and Meta-synthesismentioning

confidence: 99%

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The barriers preventing pregnant women from accessing midwife-led antenatal care in Nigeria

Nwankwo

Ezenwaka²

2020

JNEP

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Background: Nigeria records high maternal deaths despite available antenatal care services in the country. This review aims to synthesise literature on barriers affecting access to midwife-led antenatal care (ANC) among pregnant women in Nigeria.Methods: This is a systematic literature review and involved searching of studies done in Nigeria and published between 2007 and 2018. MEDLINE 1946 to present, CINAHL, JBI, and Pubmed Central were electronically searched to identify studies on barriers affecting access to midwife-led ANC among pregnant women in Nigeria. Reference lists were hand-searched, Grey literature; Google scholar, and NuSearch e-dissertation were also searched. Citation chaining was also used. Twenty articles met the inclusion and exclusion criteria while only seven out of the twenty were included in the review after quality appraisal.Results: The data synthesis of the literature review showed disproportionate absence of the use of midwife-led ANC in this population. Several barriers were identified in the various works reviewed. The identified core barriers are economic relating to issues like high costs of services, poverty, unemployment, financial barriers; personal barrier relates to lack of autonomy, greater convenience of using other services and personal preference, low maternal educational levels, lack of information on healthcare services/ignorance about required health services, maternal age, marital status, parity/number of children; environmental relates to distance to health facility, location of residence/rural dwellers, geographical location, lack of transportation, and farness of ANC service provider; and cultural barriers relates to husband’s permission, culture of patriarchy, traditional beliefs, cultural sensitivity, cultural perception of the role of TBAs, ethnicity.Conclusions: This review highlights the need to thoroughly explore and address context-based barriers affecting access to midwife-led ANC in order to make safe motherhood a reality in Nigeria. The principal solution to these identified barriers is antenatal education by midwives which will help to empower women thereby increasing their access to midwife-led ANC. \textit{Recommendations:} Government/Policy makers should allocate sufficient fund to maternal healthcare and health promotion. They should improve ANC use by making it available, accessible and affordable to all women in Nigeria irrespective of their area of residence. Also incorporate in the educational curriculum of the approved schools of midwifery in Nigeria the suggested midwifery strategies such as named midwife, team midwife, caseload midwifery.Midwives should avail themselves of update courses in midwifery; play the necessary roles of a midwife especially being women-centered; develop interest in conducting midwifery research and using the best available evidence in their practice.

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Pattern of utilization of ante-natal and delivery services in a semi-urban community of North-Central Nigeria

Cited by 25 publications

References 13 publications

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi

The barriers preventing pregnant women from accessing midwife-led antenatal care in Nigeria

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