1.1 Introduction
Reproductive health is a crucial part of general health and a central feature of human development. It is therefore an important component of health which serves as a precondition for human development as well as a central determinant of quality life. Respect for women’s reproductive rights and access to reproductive health services provides the basis for the overall well-being of the human family. The health of any society cannot be assured unless women’s access to reproductive health care services can be made available (Ujah, 2013). Unfortunately, this has been compromised due to the inability of government to provide for the necessary reproductive health services required by women as a result of other problems like accessibility, availability, affordability and sustainability. The economic and cultural factors, notwithstanding has been consider as the major factors that play very crucial roles in deepening the reproductive health crisis in the local government area (Tinuola, 2009).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Over the past health workers have been contributing immensely to the primary prevention of disease in both community and health facilities with emphasis on the front-line health workers, these are the health care providers that are available to cater for the immediate health need of the patients, according to (Agyeponget al. 2001) the Interventions to improve quality and responsiveness in healthcare have centered on professionals and frontline workers without recourse to a total system reform.
Since the 1980s’ there has been increasing awareness on the need to pay special attention on the reproductive health of women by the government. Access to the reproductive health services has long been undermined, which can be viewed as an infringement on women’s rights and compounded by other factors such as inadequate health facilities, economic, socio-cultural, belief systems and demographic factors.
Women living in developed countries of the world generally have a better access to high quality health care access, the higher percentages of their deliveries takes place in health care facilities with skilled attendants, whereby due to quality access to health care services maternal mortality or deaths has become a rare event in developed countries, where only 1% of maternal deaths occur, whereas in developing countries, these events are often fatal (World Health Organization, 2012).
According to United Nations, (2007), seventy-five percent of maternal deaths occur during childbirth and the postpartum period, and the vast majority of maternal deaths and injuries are avoidable when women have access to high quality reproductive health care services before, during and after childbirth. They were able to achieve this through successful development of systems of care to harness scares resources including human, educational and financial to maximize reproductive health; these countries were also able to meet the goals, policies and help prevent maternal mortality and morbidity (Muazu, 2009). Policies for example includes setting standards using evidence based protocols, improving staff strength and attitudes and most importantly have a long term maternal plan for the development of maternal health care (Tahir& Malik, 2002).
Appropriate reproductive health knowledge, belief and will power of women to access quality health services such as family planning services (preventive and curative) and other contraceptives means are essential for improvement in reproductive health of the women living in the area. The lack of access to quality reproductive health care services is the reason why many of them at their reproductive age suffer and die (Worku and Gebresilassie, 2008).
The inadequacy or lack of implementation of laws and policies, the prevalence of systematic corruption, weak infrastructure, ineffective health services, and lack of access to skilled health care providers worsened by separation of responsibilities for the provision of health care among the state’s three tiers of government are among the factors militating against the enjoyment of these rights (Ogundipe and Obinna, 2009). Due to this, reproductive health care in Nigeria is still typical like that of most states in Nigeria where mass poverty, illiteracy, ignorance, disease, low status of women, unrestricted sexual behaviour resulting in high population growth rate, harmful traditional practices and poor social amenities all combine to encourage reproductive ill health (Lawrence, 2014).
Carrasquillo (2013) stated that utilization is often reported as the number of services used over a period of time divided by the population denominator. Or the percentage of persons who use a certain service divided by individuals eligible to use the service. Oladipo (2014) stated that within the developing countries, differences in health status exist, based on indices such as infant mortality, young and child mortality and maternal mortality. Serious attention is required in improving quality of healthcare services to enhance it utilization, the study therefore seek to investigate the socio-economic factors that affect the utilization of health care services by inhabitants of rural areas of Plateau State.
Health Care Utilization according to Carrasquillo (2013) is “the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well- being, or obtaining information about one’s health status and prognosis. It refers to the use of health care services. Utilization can be described as the use or amount usage per unit population of health services. It stated that in health care, utilization is defined as “the consumption of services or supplies such as the number of office visit a person makes per year with a health care provider, the number of prescription made or the number of days a person is hospitalized.
Therefore, in Plateau State where the research was carried out, the activities that was conducted is to assess the Reproductive Health Care Services for Women in Barkin Ladi Local Government Area.
1.3 Statement of Problems
Investigation revealed that the utilization of service is the actual coverage and it is categorized into ambulatory medical care services (outpatient and home); inpatient services (hospital); and preventive services. To achieve optimal levels of utilization, all the three categories must enlist the cooperation and initiative of the population as well as those of the health service providers. There is at present increasing evidence, especially in the developing world, that many more who attempt to obtain such services are not getting them for a number of reasons.
In Nigeria, the discrepancy between what the levels of health care utilization are and what they ought to be is easily discernible. This underlines current efforts in relating utilization to resources as well as to past and present planning efforts. It has been said that there is need to review planning efforts and their appropriateness, especially when viewed from the context of utilization of health care services.
1.4 Aim and Objectives of Study
The aim of the study is to assess the Reproductive Health Care Services for Women in Barkin Ladi Local Government Area, Plateau State. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the impact of access to reproductive healthcare services on the health of women in Barkin Ladi Local Government Area;
- To assess the influence of educational status on utilization of reproductive health care services among women in Plateau State;
- To determine the adequacy of reproductive health care services provided to women in Plateau State; and
- To investigate the influence of attitude of health care personnel on utilization of reproductive health care services among women in Plateau State.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Is there adequacy of reproductive health care services provided to women in Plateau State?
- What is the impact of access to reproductive healthcare services on the health of women in Barkin Ladi Local Government Area?
- What is the influence of educational status on utilization of reproductive health care services among women in Plateau State?
- What is the influence of attitude of health care personnel on utilization of reproductive health care services among women in Plateau State?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no statistical significant association in the utilization of reproductive health services among women in Barkin Ladi Local Government Area.
- H1: There is a statistical significant association in the utilization of reproductive health services among women in Barkin Ladi Local Government Area.
Hypothesis Two
- H0: Socio-economic factors do not have significant influence on the utilization of reproductive health care services by rural dwellers of Barkin Ladi Local Government Area
- H1: Socio-economic factors have significant influence on the utilization of reproductive health care services by rural dwellers of Barkin Ladi Local Government Area
1.7 Significance of Study
The outcome of this study would be significant to community residents in Plateau State and Nigeria in general in the following ways:
- The findings of this study would provide information on the adequacy or otherwise of health services provided to community residents in Plateau State with a view to improving the services.
- The findings of this study would help policy makers to understand problems militating against effective utilization of reproductive health services among women in Barkin Ladi Local Government Area and the way forward.
- It would provide a basis for further research to other interested researchers.
- The findings of this study would contribute to existing knowledge on the provision and utilization of health care services.
1.8 Scope of Study
The scope of the research focuses on the Assessment of Reproductive Health Care Services for Women in Barkin Ladi Local Government Area (LGA), Plateau State.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.
