Antenatal Care: Perceptions and Practices among child bearing women in KakaboAntora Khan & Berezy MakarangaJPG SPH, BRAC UniversityFebruary 14, 2008

Contents Background Justification and literature reviewObjectives of the studyMethodologyFindingsConceptual frameworkDiscussions

Background

Antenatal care is the form of medical supervision providing services to pregnant women 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:

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

Justification and Literature Review:

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).

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 QuestionsWhat 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?

ContDoes 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; SavarStudy Population:Pregnant and lactating womenTools: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 yearsParity: mother of 1 child to 3 childrenLevel 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 changesPreviously 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 womanAge of conceptionParity 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 careRespondents 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 makersIn laws and their spousesMy 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 womanSometimes own parents

Findings Perceptions and expectationsThe service providers should visit door to doorMore patience to listen to their problemsAfter delivery service up to one monthSabina 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 eggsTheir recommended foods are more vegetablesNo cultural restrictions on work No cultural practices concerning child birth

Antenatal care: perceptions and practices

Health delivery systemLocal health facility operations

Health educationAttitude of service providers Decision makingCultural beliefs and practicesTransport facilities &Its Costs Infrastructure

Poverty Power relationship

Antenatal care: perceptions and practices

Health delivery systemLocal health facility operations Salary (?)Working environment (?)Equipments (?)

Health educationAttitude of service providers Decision makingCultural beliefs and practicesTransport facilities &Its Costs Infrastructure

Poverty Power relationship

DiscussionPoor 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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