Factors that Influence Non-Utilization of Health Care Services by Antenatal Women in Rural Area
This descriptive study aimed to examine the factors that influence non-utilization of health services by antenatal women in rural area of Use-Offot in Uyo Local Government Area, Akwa Ibom State. To guide the study, three objectives were set thus: To identify the factors that influence non-utilization of health services by antenatal women; to determine whether there is any government policy on the use of antenatal care services, and to determine the importance of utilizing antenatal care services during pregnancy.
Research questions were also formulated and related literatures were reviewed based on the set objectives. The sample size of 100 respondents was selected using simple random sampling technique. The main instrument for data collection was questionnaire. Data collected were analysed using simple percentages and were presented in tables.
Findings revealed that there are several factors influencing the non-utilization of antenatal care services by pregnant women, it revealed government policies on the utilization of antenatal care services. Findings also revealed the importance of utilizing antenatal care services during pregnancy. Based on these findings, conclusion was drawn and recommendations were also made in the study.
Factors that Influence Non-Utilization of Health Care Services by Antenatal Women in Rural Area
1.1 Background of the Study
In many developed countries, the chances of a healthy normal baby being delivered to a healthy, uninjured mother have increased greatly in recent years. Factors contributing to this happy state of affairs include a rise in the general standards of living, improved antenatal facilities and adequate antenatal care (Finlayson and Downe, 2013).
The care of the expectant mother from the time of conception until she returns to her family responsibilities after delivery is very important (Anderson, 2014). The author has also reported that many expectant mothers prefer to go to hospital to have their babies because it is safe for them to place themselves under the care and supervision of a physician.
Pell and Menaca (2013) explain that general medical supervision of the expectant mother from the earliest stages enables the physician to start treatment on time if anything is wrong. For instance, complications in pregnant women can be recognised earlier for treatment. Besides, those expectant mothers who have perfectly normal pregnancy, labour and delivery are offered, helpful guidance, re-assurance and instructions by the attendant physician to help make their pregnancy a pleasure (Birmeta and Dibaba, 2013).
According to Pell and Menaca (2013), a physician often starts the examination of the expectant mother with a healthy history to give him information concerning any childhood diseases and later illnesses such as heart trouble, rheumatic fever, diabetes, tuberculosis, or venereal disease. Histories are taken on previous pregnancies and miscarriages as well. Medical examination is carried on as follows: examination of the heart and lungs, throat, nose, ears, and teeth for any signs of infection.
Blood samples are taken for laboratory examination in order to determine the type of blood and Rhesus factor. In case a transfusion becomes necessary for either the mother or the infant, and to test for syphilis and anaemia. “Pap” or papanicolaou test is done routinely to detect cancer of the cervix or uterus. A vaginal smear is also taken and examined under the microscope for the presence of cancer cells. Most importantly, the physician gives definite instructions on hygiene, makes effective preparations for proper care at the time of child birth, and gives advice regarding regular body exercise, adequate rest and adjustment in family lifestyle (Harris and Birch, 2012).
It is often observed through careful pelvic measurement that the bones of the pelvic of the expectant mothers are narrow, making the normal birth of the child difficult or impossible. Under such situations, suitable steps are taken by the physician to ensure possible birth. These steps, according to Gage (2017) may consist of controlling the size of the child or arranging for birth by cesarean section, in which the delivery is made by way of an incision through the abdominal and uterine walls.
When considering the extent of antenatal cared given to expectant mothers, one will expect all pregnant women to receive such care. But, numerous factors exert restrictions on the extent of utilization of antenatal health care services by some pregnant women. In the study area, pregnant women have minimal access to orthodox medicine care, because at the community level, there is lack of knowledge about the importance of antenatal care and delivery in a health institution.
They maintain that certain traditional practices such as early marriage solitary confinement, patriarchy and the low socio-economic status of women create unconducive conditions for seeking prompt health care services. It is alarming, however, that even when a prompt decision is taken to seek health care, lack of financial resources for transport and hospital charges increasingly constitutes formidable dilemmas for the urban and rural class of women. These categories of women are also justifiably repelled from patronizing health facilities because of the poor attitudes displayed to them by the hospital staff. These problems are exacerbated by the inevitable breach of cultural etiquette and obstetric observances obtained in hospital settings (Antai, 2013).
However, the factor repelling pregnant women from utilizing health services for antenatal care may vary with cultural backgrounds. Hence, the present study aimed at investigating the factors that influence the non-utilization of health care services for antenatal care by pregnant women in Use-Offot Community, Uyo Local Government Area.
1.2 Statement of the Problem
The provision of antenatal care services is the most valuable and integrated approach to protecting the health of pregnant and nursing women. Such antenatal services should cater for all pregnant and nursing women with special reference to the high risk groups. For those who are destined to have normal pregnancies, labour and deliveries; some helpful guidance, reassurance and instructions help to make their pregnancies pleasurable event rather than a burden.
Several past studies have indicated that most pregnant women in the rural communities prefer hospital to home delivery (Antai, 2013; Anderson, 2014). It is therefore surprising that antenatal clinics are neglected but most pregnant women are not informed of the importance of attending antenatal clinics. However, many health workers and some concerned individuals in the society do express concern over the non-utilization of health services for antenatal care by pregnant women.
In the study area, it has been observed that some women refused to attend antenatal clinic for due to fear of operation by the doctor. Some complained lack of access road and poor facilities, while others lack knowledge about the importance of antenatal care and delivery in a health institution. From personal interview with some mothers, they complained that health services are very costly. From these observations, the researcher find it necessary to examine what factors influence the non-utilization of health services by antenatal women in rural areas of Use-Offot in Uyo Local Government Area.
1.3 Objectives of the Study
The broad objective of this study was to investigate the factors that influence non-utilization of health care services by antenatal women in rural area of Use Offot, Uyo, Akwa Ibom State.
The specific objectives were as follows:
- To identify the factors that influence non-utilization of health services by antenatal women in Use Offot Community, Uyo, Akwa Ibom State.
- To determine whether there is any government policy on the use of antenatal care services, and
- To determine the importance of utilizing antenatal care services during pregnancy.
1.4 Research Questions
- What are the factors that influence non-utilization of health services by antenatal women in Use Offot Community, Uyo, Akwa Ibom State?
- Is there is any government policy on the use of antenatal care services?
- What are the importance of utilizing antenatal care services during pregnancy?
1.5 Significance of the Study
(i) This study will help in planning, implementation and evaluation of antenatal services at the federal, state, local and community level of Government.
(ii) The findings of this study will be of immense benefit to pregnant women and women of child bearing age as it will highlight the importance of utilizing antenatal care services.
(iii) It will help the Government in the development of new policies that will promote the utilization of antenatal care services among pregnant women.
(iv) It will help to enlighten the health workers on the principles of solving the problems associated with non-utilization of antenatal care services by pregnant women.
(v) This study will also serve as a reference material for future research.
1.6 Scope of the Study
This study will investigate the factors that influence the non-utilization of antenatal care services by pregnant women. It will assess existing government policies and emphasize on the need to utilize antenatal care services during pregnancy. The study will be delimited to women of child bearing age in Use Offot Community, Uyo, Akwa Ibom State.
1.7 Operational Definition of Terms
Antenatal Care: This is a care given to a woman during pregnancy till the time of delivery.
Health: Is a state of complete physical, mental and social well being, not merely the absence of disease of infirmity.
Healthcare: Is the maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in people.
Factor: This refers to a circumstance, fact, or influence that contributes to a particular result.
Influence: This can be defined as the capacity to have an effect on the character, development, or behaviour of someone or something.
Utilization: Is the action of making practical and effective use of something.
Non-utilization: This refers to poor or non usage of something for effective outcome.
REVIEW OF RELATED LITERATURE
This chapter review related literature under the following headings: Conceptual framework, theoretical framework empirical framework and, summary of literature review.