CHAPTER ONE
INTRODUCTION
1.1 Background
Appropriate antenatal care is one of the pillar of safe mother hood initiatives; a worldwide effort
launched by the World Health organization and other collaborating agencies in 1987 aimed to
reduce the number of deaths associated with pregnancy and children. It highlights the care of
antenatal mother as an important element in maternal healthcare as appropriate care will lead to
successful pregnancy outcome and healthy babies (Nicholas, 2010). All pregnant adolescent girls
are expected to go for their antenatal checkup in the first trimester to identify and manage any
medical complications as well as to screen them for any risk factors that may affect the progress
and outcome of their pregnancy.
According to Perinatal Care Manual recently edited by the Minister of Health Malaysia,
primigravida women are advised to go for a total of ten visits during their pregnancy and for
multigravida women, the total recommended antenatal visits are seven sessions (MOHM,2010).
In different parts of the world, adolescents have been identified as the most vulnerable group in
sexual reproductive health issues (Dick,2015). This makes adolescenc , the time period between
11 and 19 years of age, the critical stage in life during which people undergo extensive biological
,psychological and social changes (Dick and Ferguson,2015).
According to UNICEF (2015), about 22 million are at risk of becoming brides before they turn
18, although government have come up with policies on adolescent health, adolescent still have
limited access to information and health services that will improve their health. These concerns
are particularly true for adolescents in developing countries who constitute approximately 70%
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of all adolescent pregnancy in the world (UN, 2012). In addition to inaccessible health
information, adolescents are faced with pregnancy-related complications, which research shows
is the second leading cause of death among girls aged 15-19 in Sub-Saharan African (Fatusi and
Hindin, 2010). Addressing the complications related adolescent pregnancies and deliveries,
WHO and UNEPA developed guidelines on preventing early pregnancies and reducing poor
reproductive outcomes. They recommend the need for increasing use of skilled antenatal and
post natal care among adolescents (WHO, 2016).
Antenatal care is more important and beneficial in the prevention of adverse outcomes when it is
sought early in the pregnancy. The WHO recommends that a woman without complications
should have at least four antenatal care visits, the first of which should take place during the first
trimester (GSS,2009).However ,research shows that pregnant adolescents are less likely than
older women to receive good ANC and skilled medical care at delivery(WHO,2006).This
disinterest has been speculated to be due to social factors such as culture, low literacy level,
inadequate reproductive health knowledge and infrequent ANC attendance. These factors in one
way or the other affect pregnant adolescents’ health seeking behaviors, which usually increases
the chances of pregnancy related complications and poor pregnancy outcomes (Mattua,2011;
Singh and Khare,2012; Ziyani et al;2011).
1.2 Problem Statement
In many research studies, low ANC compliance among adolescents has been noted (Phafoli et al
2010). Where this occurs, a large number has also been noted to have late attendance, usually in
the third trimester. For instance , following a study done at Lesotho out of the 632 pregnant
teenagers sampled 43% visited the antenatal clinic for the first time in their third trimester and
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only 14.9% attended in the first trimester,78% of the 14.9%who attended were married teenagers
(Phafoli et al 2010).It is also known that adolescence mothers have many complications and
undesired outcomes .This is because they are children themselves and their bodies are not yet
sufficiently developed to handle pregnancy and delivery. By attending antenatal clinic they
would be equipped with health information on how to care for themselves during pregnancy,
delivery and after (Phafoli et al,2010). When many adolescent mothers do not attend clinic, their
risky life situation which has been established to be worse than that of other expectant mothers
keeps them in a highly compromised situation. It has been observed that the pregnant adolescents
in Mile 16 community attend less antenatal and it is therefore important to assess their
knowledge on the importance of utilizing ANC.
1.3 Rationale
The knowledge of pregnant adolescents on the importance of ANC is therefore necessary to
establish ways of making them adapt healthy antenatal seeking behaviors.
1.4 Research Questions
1.What knowledge do pregnant adolescent is Mile 16 community have on the importance on
antenatal care
2. What factors hinder pregnant adolescents from attending ANC.
3.What are the challenges faced by pregnant adolescents in Mile 16 community on antenatal
care.
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1.5 Objectives
1.5.1 General Objectives
Assessing the knowledge and practices of pregnant adolescent girls on antennal care in Mile 16
community.
1.5.2 Specific Objectives
1.To assess the knowledge of pregnant adolescents on antenatal care.
2.To find out the factors hindering pregnant adolescents rom attending ANC.
3.To find out the challenges faced by pregnant adolescent girls in Mile 16 community on
antenatal care.