CHAPTER ONE

1.1INTRODUCTION

Antenatal care (ANC) can be defined as the care provided by the skilled health care professionals to pregnant women in order to ensure the best health conditions for both the mothers and their babies. The general components of ANC include: risk identification, prevention and management of pregnancy or concurrent diseases, health education and promotion (WHO, 2016).

Antenatal care can also be defined as the routine care of pregnant women provided by health care professionals between conception and the onset of labor. Antenatal care is an opportunity to provide care to pregnant women in order to ensure prevention and management of existing and potential causes of maternal and newborn mortality and morbidity (Bash, 2019)

Historically ANC started with the traditional ANC services model. This was developed in the early the 1900s. The model assumes that frequent visits and classifying pregnant women into low and high risk by predicting the complications ahead of time, is the best way to care for the mother and fetus. The traditional approach was replaced by focused antenatal care (FANC); a goal oriented antenatal care approach, which was recommended by researchers in 2001 and adopted by the world health organization (WHO) in 2002. FANC is the accepted policy in Ethiopia (Gudayu tw. Afrd, 2015)

Focused antenatal care also aims to give holistic individualized care to each pregnant woman to help maintain the normal progress of her pregnancy through timely guidance and advice on birth preparedness (WHO, 2014)

Focus antenatal care aims to promote the health of pregnant mothers through their targeted assessments of these pregnant mothers to facilitate:

Identification and treatment of already established diseases

Early detection of complications and other potential problems that can affect the outcomes of pregnancy (WHO)

Prophylaxis and treatment for anaemia, malaria and sexually transmitted infections (STIs) including HIV, urinary tract infection and tetanus (WHO)

According to world health organization early ANC is essential to ensure the best care and health outcomes for women and children .WHO recommends through the FANC model that all pregnant women should have at least eight contacts with a health care provider throughout their pregnancy. This should be initiated with a 1^st contact less than 12weeks gestational age (WHO, 2016 ). FANC model aims to provide pregnant women with respectful individualized person centered care at every contact, with implementation of effective clinical practice (intervention and tests; provision of relevant and timely information; provision of psychosocial and emotional support, by health practitioners with good clinical and inter personal skills within a well-functioning health system (Abou-Zahr et al, 2003 )

The objective of early ANC is prevention, early recognition and treatment of pregnancy related ailment as well as general medical problems. Early ANC also provides an opportunity for good reproductive health counseling. Early registration into antenatal clinic services is thus recommended. However, the majority of pregnant women enter late into an antenatal care programmed; especially in developing countries such as India (UNICEF, 2010)

1.2-STATEMENT OF THE PROBLEM

Many women especially in developing countries do not seek ANC services early. Some of them give reasons that they had already been pregnant and so they already know how the pregnancy evolves; so, they will only start ANC at 5months (WHO global health observatory antenatal, 2011)

More in some of the women who started ANC early, some of them do not adhere to all the education given to them during ANC. Some of these women when the start having symptoms of malaria or other ailments, they just feel that it is the normal evolution of the pregnancy and so they do not go to the hospital. In so doing some of them end up having miscarriages or stillbirths (UNICEF, 2016)

Despite education on radio and during ANC services for women to attend ANC early and follow it up effectively; some women are still not adhering to this thereby leading to complications in their pregnancy which sometimes lead to loss of their lives (Rowe et al, 2008)

WHO envisions a world where “every pregnant woman receives quality care throughout the pregnancy”? However approximately 30300 women and adolescent girls died as a result of pregnancy related complications in 2015 due to late registration into ANC.

More so, globally 85% of pregnant women between 2010 and 2016 access ANC with skilled health personnel only once. Only six receive at most four antenatal visits (which is low) in countries with the highest rates of maternal mortality such as in sub-Saharan Africa and south Asia and some of these women ended up having complications which led to their dead.

A study in Italy found a late booking clinic rate in of 32.9% and some of the women ended up with pregnancy related complications. However, rates of late booking are rather higher for countries in sub-Saharan Africa. A cross sectional survey in Ethiopia found that 44.9% of women booked for their pregnancy late and many of them ended up with pregnancy related complications which caused them to spend huge amount of monies in the hospital (UN, 2010)

ANC coverage in Cameroon in 2007 stood at 82% with 60% of pregnant women having only four ANC visits. In Cameroon maternal mortality rate has risen by 8% from 680 to 872 deaths per 100.000 in the past 9years. Some of the reasons accounting for this rise in maternal mortality rate is late registration into ANC services.

What irritated the researcher was during the researcher clinical experience at mile one regional hospital where a woman with eclamptic fit and was operated upon and the baby was kept in the incubator but later on died. This therefore motivated the researcher to “access the knowledge of women of childbearing ages (15-49years) on ANC and the importance of early registration into its services

1.3RESEARCH QUESTIONS

1. Do women of childbearing ages have knowledge on ANC?
2. Do women of childbearing ages have knowledge on the importance of early registration into ANC services?
3. What is the knowledge of women of childbearing ages on the effects of late registration into ANC services?

1.4 OBJECTIVES

1.4.1 GENERAL OBJECTIVE

To access the knowledge of women of childbearing ages (15-49years) in Bonadikombo on ANC and the importance of early registration into its services.

SPECIFIC OBJECTIVE

1. To access the knowledge of women of childbearing ages (15-49years) in bonadikombo community on ANC.
2. To access the knowledge of women of childbearing ages (15-49years) in bonadikombo community on the importance of early registration into the ANC services.
3. To access respondent’s knowledge on the effects of late registration into ANC services.