Volume 108, Issue 1 , Pages 77-78, January 2010
Perceptions among the Annang women of South–South Nigeria regarding antenatal healthcare information
Article Outline
Keywords: Annang women, Antenatal healthcare information, South–South Nigeria
Pregnancy and its potential complications can represent a major hazard for women, particularly in low-resource regions of the world [1]. Recent reports have shown that the lifetime risk of death during childbirth in Sub-Saharan Africa is approximately 400 times that in high-resource countries [2].
Antenatal care is associated with reduced rates of maternal mortality in Sub-Saharan Africa, where its favorable outcomes are attributed to the health education that women obtain from the information given in clinics [3]. However, recent reports have shown that, despite receiving formal antenatal care, many pregnant women in the geopolitical zone of South–South Nigeria deliver in facilities in which emergency obstetric care does not exist and where there is no provision for referral to hospital [4].
In South–South Nigeria, information about reducing maternal mortality is given to women via education sessions held at antenatal clinics; these sessions are designed to keep women informed about their pregnancies and to emphasize the advantages of delivery in orthodox health facilities in which emergency obstetric care is readily available.
The aim of the present study, which was conducted in 16 villages in the Obot Akara Local Government Area of Akwa Ibom State, was to evaluate the attitudes of pregnant Annang women toward orthodox antenatal care, and their understanding and implementation of health advice given during the antenatal education sessions held at the clinics. The study was approved by the Ethical Review Committee of the University of Uyo Teaching Hospital.
A survey was conducted between October 2004 and March 2005 to obtain information from Annang women on demographic variables, perceptions/attitudes to antenatal health information, and reasons for obtaining formal antenatal care. In total, 26 interview sessions were held in the 16 randomly selected villages in the Local Government Area. Each session was attended by 160–200 women aged 15–45
years and, in each session (coordinated by the authors), the women were interviewed—using pre-coded questionnaires—by student nurses, community health workers, and youth corps doctors. A total of 1560 women who had received formal antenatal care agreed to participate after due explanation and assurance of confidentiality. Both the local Annang dialect and English were used to administer the questionnaires.
The modal age group of the women was 21–30years (47.8%). The majority (82.2%) were married and 58.2% had received at least secondary-level education (Table 1). Of the respondents, 78.3% had not understood the health information they received at the antenatal clinic because: the information was too technical (41.3%); the language used was difficult to understand (26.8%); or the education sessions were too long (17.8%). No reasons were given by 14.1% of the respondents.
Table 1. Demographic characteristics of the respondents.a
| Variable | Respondents (n=1560) |
|---|---|
| Age, y | |
| ≤20 | 214 (13.7) |
| 21–30 | 745 (47.8) |
| 31–40 | 571 (36.6) |
| >40 | 30 (1.9) |
| Parity | |
| <1 | 284 (18.2) |
| 1–4 | 923 (59.2) |
| ≥5 | 353 (22.6) |
| Marital status | |
| Married | 1283 (82.2) |
| Widowed | 31 (2.0) |
| Single | 175 (11.2) |
| Separated | 71 (4.6) |
| Education status | |
| No formal education | 66 (4.2) |
| Primary-level education | 586 (37.6) |
| Secondary-level education | 768 (49.2) |
| Higher than secondary-level education | 140 (9.0) |
aValues are given as number (percentage). |
In total, 65.3% of the respondents would have preferred antenatal care information to have been given in the common dialect, whereas 34.7% would have preferred it in English. A total of 65.6% felt that the health information sessions should be held in the antenatal clinic before consulting the doctor; 13.8% favored consulting rooms while seeing the doctor; 11.6% felt that the sessions should be held in small groups in separate rooms; and 9.0% felt that the sessions could be held anywhere convenient.
A total of 23.4% of the women felt that the religious aspect (praying and singing) of the education sessions should be removed; 23.8% did not want breastfeeding to be included; 15.2% felt that care of the baby should not be discussed; 12.3% did not want dietary advice to be included; and 2.3% wanted advice about pregnancy to be removed. In total, 62.5% of the respondents wanted the sessions to be given by midwives; 32.7% wanted doctors to give the sessions; 3.8% wanted social workers to give the talks; and 1.0% wanted pastors to provide the information.
The reasons given for attending the antenatal care sessions were as follows: to appear modern (27.0%); to obtain immunization (22.4%); to listen to health information sessions (16.7%); because of husband/parental pressure (14.7%); and no specific reason (19.2%).
Despite the relatively high level of education of the participants, only 21.7% understood the health information they had received—probably because medical terms were not explained. This may also explain why 65.3% would have preferred the sessions to have been in the local vernacular only.
The important role midwives can have in improving the general health of women in the local communities of the state was highlighted by the fact that most of the respondents wanted health education to be given by midwives in the antenatal clinic (as is the current practice in most parts of Nigeria). In many rural communities in Nigeria, the antenatal clinic may be the first and only point of contact between women and orthodox health personnel.
In conclusion, the perception of health education and the understanding of the importance of orthodox antenatal care are poor among pregnant women in Annang communities. There is a need to review the content and the method of delivery of health education programs, in addition to assessing patients' understanding periodically. Staff involved in delivering health information should develop appropriate systems for evaluating teaching methods and they should modify the content to ensure that appropriate and easily understandable health messages are delivered.
Conflict of interest
The authors have no conflicts of interest.
References
- . Community perception of the causes of maternal mortality among the Annang of Nigeria's southeast coast. Trop J Obstet Gynaecol. 2005;22(2):189–192
- . Women's right to health and the Millennium Development Goals: promoting partnerships to improve access. Int J Gynecol Obstet. 2006;94(3):207–215
- . The influence of antenatal care on pregnancy outcome. Trop J Obstet Gynaecol. 1988;1(1):67–71
- . Morbidity and mortality in booked women who deliver outside orthodox health facilities in Calabar, Nigeria. Acta Trop. 2000;75(3):309–313
PII: S0020-7292(09)00504-9
doi:10.1016/j.ijgo.2009.08.023
© 2009 Elsevier B.V. All rights reserved.
Volume 108, Issue 1 , Pages 77-78, January 2010
