Lizzy 2
Lizzy 2
Lizzy 2
1.0 INTRODUCTION
The third world countries typically Nigeria sees ante-natal care to be an important tool in
mother’s health and curtailing infirmities that may alter with the health of the mother and the
Baby (Parker, 2018). Also utilization of antenatal care services among pregnant women is highly
encouraging since most women in the third world countries like Nigeria invest quality time to
always go for antenatal clinic so as to ameliorate any diseases condition that can affect the child
(WHO, 2018).
The antenatal period presents an important opportunity for identifying threats to the mother and
unborn baby’s health, as well as for counseling on nutrition, birth preparedness, delivery care
and family planning options after the birth. According to Onamade (2021), the Global
Demographic and Health survey compiler estimated that about 500,000 women die each year
from pregnancy related complications and about 55,000 of these deaths occur in Nigeria.
Nigeria’s population is only 2% of the world’s population, but yet account for over 10% of the
global maternal deaths. In 2015, the World Health Organization (WHO) and the Federal Ministry
of Health in Nigeria reported that 830 women die every day, approximately in Nigeria as a result
of 33 complications at childbirth.
Nigeria was ranked second to India globally in the number of maternal deaths (WHO, 2021).
Thus the ratios of a woman dying from child birth are 1:18 in Nigeria, compared to 1:61 for all
developing countries and 1:29, 800 for Sweden (WHO and FMOH, 2022). Antenatal care (ANC)
offers excellent opportunities for promoting maternal health. This is especially true in developing
countries where access to health care is limited. Given the potential of ANC, it has come under
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sharp focus in recent years. Increasing attention is being given to maximizing its potentials for
providing crucial reproductive health services during pregnancy as part of the continuum of care
Antenatal care is the clinical assessment of mother and fetus during Pregnancy, for the purpose
of obtaining the best possible outcome for the mother and fetus (Women Health Care 2016). The
health care that a mother receives during pregnancy is important for the survival and well-being
of both the mother and the child. The important areas to maternal health care service such as
antenatal care service; problems in accessing health care and awareness and attitude concerning
maternal health Care Service care Also essential to the survival and well-being of both . The
It is crucial to note that antenatal care is instrumental in the prevention and control of neonatal
infections which include; gonorrhea, malaria, urinary tract infection, bacterial infection.
Antenatal care according to Amentie et al., (2015) is one of the most effective health’s
Interventions for preventing maternal morbidity and mortality particularly in places where the
The World Health Organization (1996) estimates that, every minute of every day, somewhere
across the globe and most especially in developing countries, a woman of reproductive age dies
from complications related to pregnancy (Harish and Arindam). But in recent years, it has been
observed that the utilization of antenatal care services has helped in reducing maternal mortality
and morbidity and has received a significant recognition. Implementing and assuring utilization
of effective maternity care for women in the developing world is not an easy task as most
childbearing women are poor and live under harsh condition not suitable for them, while
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adequate care during pregnancy is essential, health care service utilization is extremely low
For all women of reproductive age, especially for pregnant women, utilization of health care
service is a key determinant of maternal and infant outcomes, including maternal and infant
mortality. The benefits of seeking health care are tremendous particularly in settings and
subgroups where the socioeconomic and public health resources are constrained (Alemayehu,
Haider and Habte, 2017). It is evident that timely antenatal care (ANC) is an opportunity to
prevent the direct causes of maternal mortalities and reduction of fetal and-neonatal deaths
related to obstetric complications. Thus, antenatal care is one of the recommended cares to be
According to the recent WHO recommendations, ANC should start in the first trimester of
pregnancy or early in the second trimester. If the pregnant woman has no serious health problem
and does not need special attention, only four ANC visits suffices (WHO/UNICEF, 2020).
ANC can improve certain outcomes of pregnancy complications such as eclampia, anemia and
syphilis through early detection, management and timely referral of high risk pregnancies,
Generally, ANC during pregnancy can provide an entry into the health system, and for teenagers
in particular such care may be one of the first comprehensive health assessment deemed
necessary (Reynold et al., 2016). Most importantly, utilization of ANC provides the opportunity
to teach women on how to recognize and respond to the signs of obstetric complications as they
may have little knowledge and experience in reproductive health (Reynolds, et al., 2016). The
other added values obtained from ANC service are provision of tetanus toxiod immunization
which is life saving both for the mother and infant, treatment of malaria, anemia and STIS; and
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an entry point for prevention of mother to child transmission of HIV. Provision of health advices
on birth spacing and use of institutional delivery which would significantly improve both
maternal and fetal outcomes are the other important services obtained in the process
It is worrisome that despite the importance of antenatal care service, most women do not usually
go for antenatal as a result leading to several clinical problems such as; deformation of babies as
a result of self medication, still birth, neonatal infection and so on. Several number of health
workers remain silent on the need for public enlightenment campaign to pregnant women to
always go for antenatal care so as to ameliorate some clinical diseases that are affecting a
Evidence shows that women at rural communities do not invest time strictly for antenatal care
due to negligence, poor educational background, superstitious beliefs, lack of fund to cater for
the expenses of antenatal drugs and services. Therefore, this problem necessitate this study to be
conducted so as to proffer recommendation and solutions on the need for pregnant women to
always go for antenatal care so as to remedy any disease condition that may affect a child and the
mother.
The study will revealed the level and utilization of ANC service by pregnant women in Tul
Pushit district; it will help the health personnel to know how to improve on the Strategies that
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Secondly, it is important to all pregnant women in identifying some clinical disease that can be
prevented. Health workers will find this study useful in educating pregnant women to always go
for antenatal clinics. Researchers will find this study useful for research purposes.
i. To assess the level of knowledge of pregnant women on ANC service utilization in Tul
Community.
ii. To determine if the distance of health facilities influence the utilization of ANC service
iii. To determine the effect of health personnel’s attitude toward utilization of ANC service
iv. To identify the socio demographic variables such as age, location, religion educational
level and marital status of pregnant women that influence the utilization of ANC service
in Tul Community.
The following research question was asked to guide the researcher on the course of the:
i. What is the level of utilization of antenatal care services among pregnant women in Tul
community?
ii. What extent of the distance of health facility from the targeted pregnant mothers?
iii. To what extent does the health personnel’s attitude influence the utilization of ANC
iv. Does the other demographic variable, such as age, occupation, location, marital status and
religion influence the utilization of ANC Services by pregnant women in Tul community,
Pushit district?
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1.6 SCOPE AND DELIMITATION OF THE STUDY
The scope of this study is the assessment of antenatal care service utilization among pregnant
women. The study will be limited to pregnant women living in Tul Community Pushit district.
Anaemia: A condition in which there is a deficiency of red cells or of hemoglobin in the blood,
Anemia: A condition in which there is necessary for health welfare, maintenance and protection
of someone or something.
Assessment: Is the ongoing systematic process of collecting, analyzing, and using information
learning
Awareness: Is the ability to directly know and perceive, to feel, or to be cognizant of event or
Child Birth: Childbirth, also known as labor and delivery, is the ending of pregnancy where one
or more babies leave the uterus by passing through the vagina or by Caesarean section.
Clinical Assessment: Is the process of assessment a patient in a hospital setting to ascertain the
Disease: A disorder of structure or function in a human, animal, or plant, especially one that
produces specific symptoms or that affects a specific location and is not simply a direct result of
physical injury.
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Foetus: The unborn child from the end of the 8th weeks after conception until birth
Palpation: Examine (a part of the body) by touch, especially for medical purposes.
Pregnancy: The period from conception to birth. Pregnancy begins with the fertilization of an
ovum (egg) and its implantation. Rate: Consider to be of a certain quality or standard.
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CHAPTER TWO
2.0 INTRODUCTION
This chapter deals with review of related literature of some different authors which include the
following conceptual Framework, theoretical framework and empirical studies (Pregnancy, the
aims of antenatal care, Health education during antenatal care services, Services rendered during
antenatal care, Major disorders in pregnancy and Immunization given during pregnancy).
Longman, (2021) defined antenatal care as an advice, supervision, attention, and medical care
given to a pregnancy women during pregnancy labor and puerperium including family planning
the health worker must be aware of the conflict and fear that can be so disturbing to the expected
mother. A successful health worker is the one with certain qualities or characters which include
showing love to his/her patient care, patience and a person who keeps confidential secret. In
adequate socio economic, cultural factors and poor nutrition affect the health of the women.
The pregnant women should be seen every month starting from the confirmation of pregnancy.
When the pregnancy rich 36 weeks, the woman will visit clinic/hospital weekly until delivery
mean while the woman is free to visit the clinic any time she fills, sick or any time she notices
any abnormalities pregnant women should be encouraged to attend antenatal care early either in
the health centre, private maternity or in the hospital, because good antenatal care will reduce the
At each visit the following should be checked e.g weigh, height, Hb, Blood pressure foetal heart
beat, presentation of the baby including Fundal height (Palpation). Also anemia can be checked
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and any abnormalities should be detected and all the findings will be recorded on the antenatal
card.
Advice will also be given in order to make them understand that there is need for them to eat
balance diet for health, and that of her unborn baby including personnel hygiene. There are
maternal morbidity which occur as a result of under utilization of antenatal care which include
obstructed labor, anemia hemorrhaged, pre-eclampia, eclampia are common causes of maternal
morbidity rate in childhood which is generally preventable Birth related infections are common
problem of women during puerperal period. According to safe mother hood, sepsis infection
arising during birth is a leading cause of maternal death in developing countries. Antenatal care
is the clinical assessment of mother and fetus during pregnancy, for the purpose of obtaining the
best Possible outcome for the, mother and fetus (Women Health Care. 2016).
The theoretical framework is conducted using several subtopics that include the following:
2.2.1 Pregnancy
Adams (2016) stated that pregnancy is a condition where by a women is having a developing
embryo of fetus in her body. It starts from conception to the delivery of the fetus. The normal
duration is 280 days (40 weeks or 9 months and 7 days) counted from the first day of the last
normal menstrual period, Pregnancy or conception. According to Myles is a fusion of the sperm
with secondary oocyte (ovum) to form the “Zygote” the process take about 24 hour and normally
i. First trimester
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iii. Third trimester
First Trimester: These trimester start from the day of conception to the three months of
gestation in the trimester, the feotus starts to develop in the uterus. This trimester is a very
delicate process because deformities may occur to some due to hormonal imbalance,
malformation of genes and the effect of some drugs. The first three months is a time where the
organs and other parts of the body are forming the placenta transmits oxygen and nutrients from
Second Trimester: This trimester starts from the fourth month to the sixth months of gestation.
This trimester is more stable, and there is less risk of miscarriage. There is quickening which is
the first Feotal movement felt by the woman at approximately 18 th to 20th weeks in primigravida
Third Trimester: It starts from seventh months to the ninth months of gestation the feotus need
adequate nourishment for proper growth and development. There is lightening, which is being
experienced in the late state of pregnancy. When the presenting part sinks in to the pelvis and the
cease 10 press on the diaphragm, It occurs shortly before the unset of labor in multigravida and
In the past mothers lost their life due to poor antenatal care there was more maternal mobility
i. To produce a life, mature and healthy baby by a healthy mother at the end of pregnancy
ii. To prepare the mother for toward pleasant child bearing experiences (adequate
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iii. To detect early and treat any risk condition that may endangers the life of the women and
her baby.
iv. To have the mother immunized through tetanustaxiod vaccine (TT) so that she pass on to
her baby.
v. To have mother strong enough for lactation to feed and care for the baby and to teach
(Clarke 2021) Health Education is define as advice given to pregnant mothers either individual
or groups in the health facility during ante-natal care services or Health education is usually in
The Health education should be presented in a simple manner that the women will understand
what you are saying and also practical demonstration will make them understand more.
A good balance diet which contains the six classes of food nutrients in adequate amounts and
i. Protein: Is baby building and energy food e.g Meat, Egg, Fish, Beans, Milk e.t.c
ii. Carbohydrate: Energy giving food e.g Maize, Rice, Yam, Cocoyam, Potatoes, Guinea
Corn e.t.c
iii. Vitamin: Is for protection e.g Orange, Onion, Tomatoes, Water, Melon, Pepper green
iv. Fats and Oil: Is for production heat e.g Palm oil, Groundnut Oil, Butter, Fish and Fats
v. Minerals: For protection and building of bones e.g salt Potassium, Carrot, Onione.t.c
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vi. Water: Which contain hydrogen and oxygen (H 2O) it constitute the largest part of body
fluid.
ii. Clothing
v. Family planning
First visit
Registration/Booking
Registration: Is the act of accepting a client or pregnant woman in to the health facility there are
1. Antenatal care hand card: It is also referred to as number which contain personal data of
the woman e.g name age, address date, occupation and the date of next visit
2. Antenatal care card: The personal data of the woman is recorded in PHC set up the
woman goes with her card while in the hospital the cards are been kept in the hospital in
their visit days the cards are given to them the following information are recorded:
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ii. Family and social history
The following are also recorded height; weight blood pressure and routine test for pregnant
History taking Jack, (2022) this should take the form of friendly-discussion with the
client, which will later make the client feel comfortable and the health worker will then
gain the client confidence. In obtaining the required information. The health worker
should explain to her why some questions may seem irrelevant to her pregnancy are
asked. The health worker should use the language that the woman understands for good
communication. It is useful to provide privacy, so that the woman may feel confident to
say what she probably consider secret. The health worker should also give her time to
the calculation of the gestation period. The date of the last menstrual period should be
ascertained because the date is the common problem in the antenatal booking clinic. The
first day of the last menstrual period should be obtained as this is used in calculation of
the expected date of delivery (The average duration of pregnancy is calculated from the
first day of the last menstrual period is about 40 weeks. We usually estimate the EDD by
adding 7 days to the day of last menstrual ) period (LMP) and counted back 3 months for
example if the woman’s LMP began on the 2 nd June, the EDD would be 9" march 2020.
Ovulation occurs on the 14 day, and fertilization can only take place thereafter.
Ahmed (2016) the health worker must be aware of the condition that can be so disturbing or
problem some to the expected mother health worker must be willing to listen and given
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sympathetic advice, will often help the woman to face any difficulties. The health worker must
be careful, cheerful and sympathetic so that women will know that child bearing is natural event.
What the woman need is the assurance that the physically and psychologically she is secure
Myles (2016) the attitude of a caring husband is essential for emotional stability of the pregnant
woman it is expected that the husband should have some understanding of the physical and
pregnancy makes some women aggressive at that time, but the husband should exercise patience.
Abdominal Examination
Sally Husband (2016) says that you need to explain to the woman what you are going to do
before starting encourage her to empty her bladder to make palpation easier and prevent
discomfort. Ask her to lie down on her back with the head and shoulder raised on a pillow. Wash
your hands and warm them to avoid reaction to cold hand and the abdominal examination should
b. Shape, a primigravida will have strong abdominal muscle while multi-gravida will
c. Scars: This may indicates surgery that might affect the uterus e.g caesarean
ii. Palpation of the Uterus: During Palpation you will examine the uterus and fundus by
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a. Fundus Height: The fundus of the uterus is palpable using hands. The measurement state
from public bone to the fundus from 20 weeks of gestation the fundus height should
increase by KM per week and tape is used in the measurement. Fundus height is also
measure by using finger that fit between the fundus and landmark (2 finger each for four
weeks) if the fundus is too high in early pregnancy missed the gestation period may be
b. Lie: In carryout this, you place your hands on the either side of the abdomen and
gradually move then downward from the fundus, you can feel longitudinal lie which is
between the hands; the fundus is felt across the abdomen in a transverse lie. The lie can
be determine from about 28 weeks but can change frequently because it is still movable
c. Presentation: The part that occupies the lower part of the uterus which includes Cephalic
the head which is the normal one, brown face shoulder and breech presentation use both
hands to find the head, which feels nards and rounded which is removable from side to
side unless fixed on the pelvic inlet. The breach presentation feels more irregular and
d. Position: Walk your hands across the abdomen the fetal spine curve gently and feels
harder than the front of the body which fell lumpsy because of the limbs. If the position is
left occipital anterior the fetal head is well fixed and when it is right occipital posterior
the feotus head is deflexed. During palpation the ulna border of the left hand is placed on
the fundal area and this is carefully palpated to determine a wether the head or breach
occupied. The fundus hand is placed on either side of the abdomen. In this palpation the
health worker faces the patient. During examination the back of the spine of the foetus is
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identify soft while the limbs felt as irregular shape, the engagement of the fetal head
usually descent into the pelvic brim at the last month in primigravida and during labor in
multigravida.
iii. Auscultation: These involve listening to the fetal heart sound (fits) the fetal heart beat
can be best heard at the back of the feotus using the fetal scope and the heart beat can be
heard at 20 weeks of gestation. It should be twice the rate of the mother heart beat.
Mrs. Dashe (2007) said that the most common complication of pregnancy which causes maternal
Abortion: Is the interruption of pregnancy before 28 weeks of gestation. The cause of abortion
i. Hormonal imbalance
i. Vaginal bleeding
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iv. Lower abdominal pain due to uterine contraction
Management of Abortion
i. Computer Bedrest
v. Analgetics are given to reduce pain e.g paracetamol and routine drugs of folic acid
vi. The abdomen should abstain from sexual intercourse for a while
Olmer (2022) stated that anemia is a condition in which the blood haemoglobin (Hb) level is
below normal range for the patient Age % Sex male have higher Hemoglobin than female and
the Hb level of 12gidl and above is normal but about 95% of anemia ceases during pregnancy are
Iron deficiency is the common cause of anemia and is aggravated during pregnancy by the
iii. Dizziness
iv. Headache
v. Fatigue
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vi. Oedema
Causes of Anemia
iii. Haemolysis due to congenital abnormality of the red blood cells and other infection
Management of Anemia
i. The woman should eat balance diet rich in protein, vitamin and minerals
ii. In mild cases give oral iron drugs like folic acid, ferrous sulphate, vitamin B e.t.c
Pre – eclampsia
pressure. Pre-eclampsia usually begin after 20 weeks of pregnancy in a woman whose blood
pressure had been normal it can lead to serious even fetal complication of both mother and baby,
also pre-eclampsia with pre-eclampsia you might have high blood pressure, high levels of protein
iii. Oedema
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Causes of pre — Eclampsia
The exact cause of pre-eclampsia likely involves several factors. Experts believe it begins in the
placenta – the organ that nourishes the foetus throughout pregnancy early in the pregnancy, new
blood vessels develop and evolve to supply oxygen and nutrients to the placenta. In women with
pre-eclampsia these blood vessels don’t seem to develop or work properly problems with how
well blood circulates in the placenta may lead to the irregular regulation of blood pressure in the
mother.
Management of Pre-eclampsia
i. Vital sign, blood pressure and urine should be closely check and monitor
ii. The woman should be on bed rest and lie on dorsal position with the rest and lie on dorsal
position with the legs elevated with pillow to reduce too much accumulation of fluid in
iii. The woman should be admitted for close supervision and care
Eclampsia
Eclampsia is a rare but serious complication of pre-eclampsia eclampsia is when a person with
pre-eclampsia develops seizure (convulsion) during pregnancy, seizure are episodes of shaking,
Eclampsia typically occurs after the 20th week of pregnancy, its rare and affects less than 3% of
people with pre-eclampsia, eclampsia can cause complication during pregnancy and requires
i. Severe headache
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iii. Abdominal pain (especially on the upper right side)
Causes of Eclampsia
Eclampsia typically develops from pre-eclampsia high blood pressure (from pre-eclampsia) puts
pressure on your blood vessels, there can be swelling in your brain, which may lead to seizure
Complications of Eclampsia
i. Placental Abruption
iv. Death
Management of Eclampsia
iii. Constant check of the vitall sign including fetal heat beat
iv. Infusion of 5% destrone 500mls laxis and diazepam injection continue checking the
blood pressure.
Ante- partum hemorrhage (APH) is usually defined as bleeding from the canal after 24 th week of
pregnancy or ante-partum hemorrhage is a bleeding from the genital tract which occurs before 28
It can occur at any time until the second stage of labor is complete
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Signs and Symptoms of Ante-Partum Hemorrhage
(suggesting preevia)
i. Placenta Praevia
i. Premature Labor
ii. Anemia
iii. Infection
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Postpartum Hemorrhage
Post Partum Hemorrhage is severe bleeding after giving birth. It’s a serious and dangerous
condition. It’s a serious and a dangerous condition PPH usually occur within 24 hour of child
birth but it can happen up to 12 weeks postpartum when the bleeding is caught early and treated
ii. Dizziness
ii. Late postpartum hemorrhage: This type occurs 24 hours to 6 weeks after delivery
Management of PPH
i. Hospitalization is important whether bleeding is slight or severe any woman who bleed
ii. Vaginal examination should be avoided as many induce profuse hemorrhage which
maybe uncontrollable
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vii. Blood transfusion
Descriptive co relational study was carried out on 90 eligible pregnant women. Data were
collected with a self-administered questionnaire and analyzed with the help of a statistician using
the Epi Info version 7 computer programs. The results of the study indicate that most women
initiated ANC later than the recommendations by the World Health Organization (WHO). Over
half of the respondents had overall good knowledge of ANC, but lacked knowledge of
medication and screening tests done during pregnancy, some danger signs during pregnancy and
of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC
were current employment status, number of children, transport costs to clinic and number of
antenatal visits.
Sumera, Aftab and Savera (2018) conducted a study on factors affecting the utilization of
antenatal care among pregnant women, a literature review. Antenatal care is the care given to
pregnant women in order to have a safe pregnancy and a healthy baby. Antenatal care is an
important determinant of high maternal mortality rate and one of the basic components of
maternal care on which the life of mothers and babies depend. Thus, Antenatal care is a key
strategy to improve maternal and infant health. Different studies have found that inappropriate
Recently the technical working group of World Health Organization has recommended a
minimum level of care to be eight visits throughout the pregnancy to reduce the maternal
morbidity and mortality. Several studies conducted in different countries on demographic and
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socio-cultural factors influencing use of maternal health care services, have shown that factors
like maternal age, number of living Children, education, place of residence, occupation, religion
and ethnicity are significantly associated with use of antenatal care The findings of various
factors associated with utilization natal care have not en pure review to been Synthesize
collectively, Therefore, there was a need to carry out a literature review to synthesize findings
Collectively regarding the factors affecting the affecting antenatal care utilization of ante-natal
care.
Hence the objective of this literature review was to appraise the factors affecting the utilization
among pregnant women the findings of this literature review could help in planning and
development strategies for utilization of ante-natal care (ANC) among Pregnant women.
This chapter with review of related literature of some different authors which Include the
following conceptional Framework, theoretical framework (Pregnancy, the aim of antenatal care,
health education during antenatal care services, Services rendered during antenatal Care, Major
Empirical studies and Summary on review of related literature Antenatal care as an advice,
supervision, attention, and medical care given to pregnancy women during pregnancy labor and
puerperium including family planning the health worker must be aware of the conflict and fear
that can be so disturbing to the expected mother. A successful health worker is the one with
certain qualities or characters which include showing love to his/her patient care, knowledgeable,
patience and a person who keeps confidential secret. Inadequate socio – economic, cultural
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CHAPTER THREE
RESEARCH METHODOLOGY
3.1 INTRODUCTION
This chapter discusses the research methodology under the following; research design, study
area, population of the study, sample and sampling techniques, instrument for data collection,
The research design that was employed in this study was survey that was used in ascertaining the
objective of the study. Hence this design was chosen to gain access to population of the study as
generalizable.
The area of study is Tul Community in Pushit District, Mangu Local Government Area of
Plateau State. The major tribe in Tul is predominantly the Mwaghavul people and other tribes
like the Ngas, Igbo, Mupun and others Tul is located at the south east of Mangu Local
Tul community of Pushit district is blessed with facilities such as health facilities, nursery,
primary and secondary schools with tertiary institution respectively. Medically the inhabitant
benefit from primary health care (PHC) and clinic establish by Government and private
individual and are mostly located in the nearby village around the area of study. The inhabitants
of Tul community of Pushit district are 85% farmers there are few business persons and other
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The major crops produce in Tul community are Maize, Irish Potatoes, Groundnut, vegetables
such as tomatoes pepper and others. With many other basic infrastructures like road leading in
The sampling techniques that was employed in this study was simple random sampling
techniques was drawn from cluster community with the total population of 450 women of child
bearing age gotten from Health facility Register that is, Antenatal care register and postnatal
register respectively. 100 were selected as sample size for the study.
A self developed questionnaire containing questions in two parts namely: Section A and B.
hence A will contain personal data of the respondents and B will contain questions based on the
objectives of the study the questionnaire will structured based on multiple opt one to ascertain
The questionnaire will be administered personally to the respondents by the researcher, the
questionnaire was read out to the respondents who are not literate (by the researcher) so that they
can make their choice from the options provided and thereafter, the questionnaire will be
This study will utilize simple percentages for analysis and presented all data and variables in
frequency distribution tables. Hence this method of suitable for this study because it is easier to
comprehend
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X= Y/100 x 100/1
Where
X = unknown
Y = number of responses
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CHAPTER FOUR
4.1 INTRODUCTION
This chapter deals with data presentation and analysis of results. A total number of 100
questionnaires were administered to respondents at random. All the questionnaires were and used
for analysis using simple percentages and presented in frequency distribution. Tables as seen
below:
≤ 20 Years 20 20%
21 – 30 Years 40 40%
31 – 40 Years 25 25%
41 – 50 Years 15 15%
From the above table values, 20 (%) respondents of the women were below are 20 years, 40 (%)
respondents were between 21-30 years, 25 (%) of them were between 31-40 years, 15 (%)
respondents were between 41-50 years and the remaining 25 (%) respondents were above 51
years, therefore the highest respondents in this category are those between age 21-30 years
(40%)
Civil/Public 25 25%
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Full Time House Wives 50 50%
Traders 25 25%
From table 2 above, 25 (%) respondents of the women identified their occupation as civil
services, 65 (%) respondents of them were full time house wives and the remaining 8 (%)
respondents of them were traders, therefore the highest respondents are the full House Wives
with 50%
No education 10 10%
From qualification of Women Within the community 8 (%) respondents had no formal
education, 20 (%) respondents of them attended Primary Level of Education, 40 (%) respondents
attended Secondary Level of Education and the remaining 30 (%) respondents attended Tertiary
Level of Education, which shows that those in secondary level have the highest responses (40%)
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Table 4: Religion Distribution
Christian 60 60%
Islam 40 40%
Traditional 0.0 0%
From the table above shows that 60 (%) of the respondents were Christians, 40 (%) are Islamic
worshipers no respondent were Traditional worshipers with 0.0% therefore this shows that the
The table above on the study on source of antenatal care services presented 39 (%) respondents
were of the assertion that health workers are the Primary source of ANC but 1 (%) respondent of
them identified trained by Traditional birth attendant and none identified untrained Traditional
birth attendants. A total number of 60 (%) respondents of the majority shows that community
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Table 6: Ante-natal care Services visited when pregnant
YES 98 98%
NO 2 2%
From table 6: Above shows the value of 98 (%) of the respondents were of the assertion that they
usually visit the ante-natal care services when they were pregnant, while 2 (%) respondents did
not visit ante-natal care when pregnant, this clearly shows that most women visit ante-natal care
2nd 47 47%
From table 7 above shows 33 (%) respondents attended first ANC Visit at first trimester, 47 (%)
respondents attended 2nd trimester while 20 (%) respondents attended 3 rd trimester. This clearly
shows that most of the women in the community attended ANC at 2nd trimester.
Hospital 33 33%
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Traditional Birth Attendant 1 1%
House 0 0%
None 0 0%
From the table value showed 33 (%) respondents attended their first ANC Visit in hospital, 66
(%) respondents attended their first ANC Visit in maternity in their community, 1 (%)
respondents attended their ANC in Traditional birth attendant. And none attended in house. This
indicated that most of the women attended ANC in maternity and hospital in community.
YES 10 10%
NO 90 90%
Table 9 value showed that 10 (%) admitted that they were aware of the complication that may
arise during pregnancy, while 90 (%) of the respondents do not know the complications that may
arise during Ante-natal. This implies that most women with 90% do not know about the
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Table 10: Access to the Health facilities
YES 98 98%
NO 2 2%
Table 10 above shows 98 (%) respondents said they have access to health facilities and the
remaining 2 (%) respondents said they do not have access to health facilities. This implies that
majority of the respondents within the research area have access to health care facilities.
Table 11: Distance from the House to the nearest Health Care Center?
1KM 60 60%
2KM 15 15%
Table 11 shows that 60 (%) respondents asserted that the distance between them and their health
facility is 1 km. 15 (%) respondents identified 3 km to 4 km and the remaining 5 (%) identified
5km and above. This indicates that most of the respondents live close to health care facility
Foot 60 60%
33
Care 15 15%
Motorcycle 20 20%
Tricycle 5 5%
Donkey 0 0%
From the table above shows 60 (%) respondents of women usually attended ante – natal clinic in
the facilities by foot. 15 (%) respondents go for ANC in the facility using car, 20 (%)
respondents go for ANC in the facilities by motorcycle and 5 (%) respondents go for ANC
facility using Donkey.. This clearly shows that most of the women go for ANC service using
foot.
attended to quickly
From table 13 above shows 40 (%) respondents of the women complaint that they usually spend
much time before they were attended to during ante-natal visit, 35 (%) respondents of women
said they were being attended to quickly, 25 (%) respondents complaint they were not always
34
attended to promptly. This implies that most of the women were not treated well during ante –
natal visit
Table 14: Do they have sufficient Health women in the Health centers?
YES 10 10%
NO 90 90%
From table 14 above shows 10 (%) respondents of women said there were sufficient health
worker in the health centre. While 90 (%) respondents’ women lamented that there were no
sufficient health worker in the health care facility, this clearly shows that there is shortage of
Table 15: The Attitude of Health Personnel in the Health Care Centre
Poor 20 20%
Manageable 30 30%
From the above table 15, 50 (%) respondents shows that attitude of health personnel’s in the
health care centers was very positive, 20 (%) shows that attitude of health personnel’s in the
health care centre’s is poor, while 30 (%) respondents said that the attitude of health personnel in
35
the health centre is manageable. This clearly shows that most of the health personnel in the
This study revealed that there was a significant relationship between distance to health facilities
and the utilization of antenatal care service among pregnant women in Tul Community in Pushit
District, Mangu Local Government Area of Plateau State. The finding was consistent with that of
Falkingham (2003) in India, whose finding also revealed that utilization of antenatal care service
is directly influenced by distance, Other similar studies whose results supported this finding is
that of Bashour et al, (2008) and NPC (2009) who respective studies found that distance from
health facility directly affected the attendance of women for ANC services. The findings of
Amentie et al., (2015) which strongly supported the findings of this study noted that women who
live in less than 60 minute walk from the health facility was 6.73 times more likely use ANC
Although several findings in other studies supported that of this study, the result of Ewa et al.,
(2012) indicates there was an insignificant negative association between distance and utilization
of ANC and delivery services. A finding in this study also revealed that the attitude of Health
Personnel in the health facilities significantly influenced the utilization of ANC services by
pregnant women in Tul Community in Pushit District, Mangu Local Government Area of Plateau
State. This finding agreed with a study by Moore et al. (2007) who noted that factors responsible
for non utilization of health facility for delivery among others includes unfriendly attitude of
staff of the health facility, unavailability of staff at health facility, lack of emergency unit in the
health facility and previous uneventful delivery at the health facility. It was also found that
although the attitudes of health personnel did significantly influence the utilization of ANC, the
36
extent to which health personnel’s attitude influence the utilization of ANC wall small. As
majority of the women utilized ANC. And this is supported by Chukwuma et al (2015) who in
his study showed that the level of utilization of orthodox health care facilities for antenatal care
It is also found that the Educational background of pregnant women in Tul community of Pushit
district Mangu Local Government of Plateau State significantly influenced the utilization of
ANC services.
In agreement with the findings of this study was that of Nagdeve, & Bharati (2003) who noted
that women who had some form of education also had a tendency to a greater awareness of the
existence of maternal healthcare services and understand the benefits in utilizing them. Amentie
et al (2015), in his study also had a similar result where it was found that women who were O
level holders and those with higher educational degrees, utilized ante-natal care more than those
who were not educated or just primary school level. They also found out that the educated
women were more knowledgeable on ante-natal care services than the uneducated women.
It was also found that the level of utilization of ante-natal care services by pregnant women in
Tul community of Pushit District of Mangu Local Government of Plateau State is very high and
that socio-demographic variable did not influence the utilization of ANC on level of usage of
ante-natal care services respondents. The findings of this study is similar to that of Adewoye et
al., (2013) which revealed that majority of the respondents in his study utilized the services and
also had a good knowledge of what it was all about. Although Chukwuma et al., (2015) found
that location, religion, socio – economic status had influence on the utilization of ante-natal care
service; his findings is contrary to that of this study in which all these demographic variable did
37
CHAPTER FIVE
5.1 SUMMARY
This study investigated assessing the utilization of antenatal care services among pregnant
women in Tul community of Pushit District of Mangu Local Government of Plateau State. To
achieve the objectives, four (4) research questions were drawn. Important Literatures were
sourced and discussed using important headings according to the aim of the study. The
methodology used in conducting this study was primary method that employed the used of
questionnaire in generating data, the sample size of 100 pregnant women were sampled from
Primary Health Care hospital within Tul community. The research design used in conducting this
study was cross sectional survey. The sampling techniques used in this study were simple
random sampling techniques. The method of data collection was through face-to-face contact
with the respondents and administration of questionnaire to elicit useful information. The
statistical tool used in analysis was simple percentages and data was presented in frequency
distribution tables. The results of the study was presented and use for conclusion and
recommendations.
5.2 CONCLUSION
The source of information about antenatal clinic in Mangu Local Government area is from
community health workers and others working the Primary health care centers Tul community.
The appropriate time for attending clinics or hospitals for antenatal is when a woman is when a
women is pregnant but most of the women usually wait till 2 nd trimester followed by fever in 1st
trimester in hospitals across Mangu Local Government Area. It is proving that most of the
women were not aware of the complications that usually arise during pregnancy that will warrant
38
for attending antenatal care to ensure the safety of the pregnancy. It is important to note that
during antenatal care a woman will be weight, test and assess to ensure they do always go down
with any diseases that may alter with the development of the baby. To ensure such do not happen
Women were given prophylactic drugs to prevent against any diseases. The attitude of health
Personnel in the health care centers is very positive and fewer of them have bad attitude towards
Women attending antenatal care, that was way some pregnant women complaint that they spent
much time waiting before they were attended to as a result they usually quarrel with the health
5.3 RECOMMENDATIONS
From the findings of the research works; the researcher has the following recommendations.
i. Health workers should educate ignorant women on the importance of antenatal health
ii. Antenatal care should be made affordable and cheap even to the common man or free to
iii. The government should build more maternity centers and Hospitals so that those who
could not utilize the service because of the distance will have opportunity to do so.
iv. Government should employ more staff man-power (health workers) in the Primary
v. Government should make provision for antenatal drugs and equipments adequately
vi. Advocators/health practitioners should organize talks, seminars and workshops for
women to update their knowledge on the need for antenatal health care services.
vii. Provide free education to all girls child and free adult education
39
viii. Pregnant women in Tul community of Tul Community, Pushit District should be
The study could be duplicated to the whole district of Pushit to enable generalization of findings
on a large scale. A study could investigate the reasons why some women visit private health
An in-depth study could be done on limitations, timing, knowledge and utilization of antenatal
care by pregnant
40
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43
QUESTIONNAIRE APPENDIX I
Technology Pushit.
P.M.B. 300,
Department of Community
Health.
25th/05/2024.
Dear Respondent,
I am a student of the above mentioned institution, currently conducting study on “The Assesment
of the Utilization of Antenatal care Service among Pregnant Women in Tul Community of
The purpose of this questionnaire is to collect data on the study of the above mention topic.
Please do supply the best information as you-can. Your objective responses to the questionnaire
will contribute greatly to knowledge and will be utilize for the purpose intended. Please kindly
respond to the questionnaire, all information provided will be treated as highly confidential.
Yours faithfully,
(Researcher).
44
SECTION A
level
High [ ].
SECTION B:
2. Did you visit the antenatal care service when pregnant? Yes [ ] No [ ].
3. At what level of the pregnancy did you attend your first ANC: 1 st Trimester [ ], 2nd
4. Where did you attend your first ANC Hospital [ ], Maternity in your community [ ],
6. Where did you deliver: Hospital [ ], Maternity in your community [ ], Traditional birth
7. Are you aware of any complication that may arise during pregnancy? Yes [ ], No [ ].
movement [ ], Overnight [ ]
45
10. What is the distance from your house to the nearest health care centre? 1 km[ ], 2km
14. If yes, what form of preparation do you make? Provisions for clean clothes [ ], prepared
for clean instruments for delivery [ ], preparation for transport if needed to a health
15. Do you prefer home delivery or the hospital? Home delivery [ ], Hospital delivery [ ].
privacy reason [ ], Against the local custom [ ], It’s safer [ ], No permission from
17. What are the conditions of the health care centre’s and their personnel’s? Very neat [ ],
18. What is the attitude of the health personnel’s in the health care centers? Very positive [ ]
Poor [ ], Manageable [ ].
19. Were you attended to quickly or you spend much time during antenatal visits? I spend
20. Do they have sufficient health workers in the health center? Yes [ ] No [ ].
46
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