Antenatal Care: Perceptions and Practices among child bearing women in Kakabo

Antora Khan & Berezy Makaranga JPG SPH, BRAC University February 14, 2008

Contents
Background Justification and literature review Objectives of the study Methodology Findings Conceptual framework Discussions

Background
o Antenatal care is the form of medical supervision providing services to pregnant women o Carla et al (1990-2001) reported that there are potential benefits which can be gained by developing countries from antenatal care services

Justification and Literature Review:

o Majority of the women living in the developing countries succumb pregnancy related complications which may be prevented few antenatal care. o There are various perceptions and practices which are influenced by socioeconomic and cultural factors.

Justification and Literature Review:

o The maternal mortality rate in Bangladesh is 3.2 per 1000 live births which is one of the highest rates in the world. This reflects inadequate maternal health care services and awareness (lutfun, Rahman and Akhtar).
o There might be a gap of knowledge on motives which drives child bearing women attending antenatal care.

General Research Question

What are the perceptions and practices of antenatal care among the child bearing women?

Specific Research Questions

What do the women of Kakabo know about antenatal care? Are there any ante natal care facilities in Kakabo? What are the existing antenatal care services provided by the health centre? Do the women have access to the antenatal care services?

Cont
Does SES play any role having antenatal care? Is there any role of family members in deciding whether the pregnant women should attend the antenatal care? Are the pregnant/child bearing women satisfied by the available antenatal health care facilities? What are the cultural beliefs associated with the antenatal care?

Methodology:
Study area: Kakabo village; Savar Study Population: Pregnant and lactating women Tools:

Focus group discussion one (1) In depth interviews four (4)

Findings
Respondents:
Childbearing women which included the

pregnant women and lactating mothers

The informed consent was obtained and they were explained that their responses will be confidential.

Findings
Respondents:
The age range: 19-30 years

Parity: mother of 1 child to 3 children Level of education: Illiterate to schooling up to standard 5

Findings
Knowledge about the antenatal care Concepts of pregnancy and pregnancy care Physical, psychological and behavioral changes
Previously it was only my household works and now I have to consider on how to take care of my child as well. - Anjali, 22 years old woman

Age of conception Parity and care

Findings
Existing antenatal care facilities and sevices One local government health centre but not functioning regularly only vaccination
Except for the vaccines, no other services are provided; even if we go they don't pay attention to our problems. Anjali, 22 years old woman

Majority didnt find the benefit from attending the care

Findings
Access and barrier of women to the antenatal care Respondents were not sure about their access
I was in need of care during my pregnancy and I didnt manage to get it in my locality so I had to go to the city -Aroti, 25 years old woman

Findings
Decision makers In laws and their spouses
My husband was very co-operative; he got the kathi (pregnancy strip) for me and took me to the health check up monthly till the end of my delivery. Uma, 20 years old woman

Sometimes own parents

Findings
Perceptions and expectations The service providers should visit door to door More patience to listen to their problems After delivery service up to one month
Sabina 23 years old woman, I had my delivery done in the hospital and my baby was fine. After few months she became weak and day by day she is getting weaker. I dont know why that is and still cant solve the problem. Im much tensed about my baby and moreover my mother in law scolds me every time that I cannot feed her properly.

Findings
Cultural beliefs Foods forbidden during pregnancy are mirka fish, pungkash fish and duck eggs Their recommended foods are more vegetables No cultural restrictions on work No cultural practices concerning child birth

Antenatal care: perceptions and practices

Attitude of service providers

Decision making

Cultural beliefs and practices

Local health facility operations

Power relationship

Poverty

Health education

Transport facilities & Its Costs

Health delivery system

Infrastructure

Power relationship

Decision making

Cultural beliefs and practices

Health education

Attitude of service providers

Antenatal care: perceptions and practices

Salary (?) Working environment (?) Equipments (?)

Local health facility operations

Transport facilities & Its Costs

Health delivery system

Poverty

Infrastructure

Discussion
Poor interpersonal relationship between pregnant women and the health care providers, Barriers in accessing the health care services including physical as well as financial influences the perceptions ad practices among child bearing women on antenatal care. However, some of these women had much expectation in getting more information and care provided by modern health practitioners.

Conclusion
In order to improve the situation of these women the macro level has to integrate the health delivery system, so that it reaches the community where people still have the demand.

As the previous literatures revealed that maternal mortality is still high in this country we suggest that the following should be implemented. Increasing coverage of provision of antenatal care, interpersonal relation should be taken into broad account as this may contribute in motivating child bearing women to attend the services.

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