1.1 Introduction
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period (Mehari et al., 2013). Access and utilization of quality health services during pregnancy, at the time of delivery and in the post-natal period is critical for the survival and well-being of the mother and newborn (Shrestha, 2017). Maternal mortality is a major global health problem particularly in low- and middle-income countries (LMIC), and the huge inequality between the high and the low-and middle-income countries remains a great sustainability concern. In sub- Saharan Africa, Nigeria continues to be one of the countries with the poorest maternal health outcomes with a mortality ratio of over 1000 per 100,000 live births in its Northern region. While there are many determinants of maternal mortality, low utilization of maternal health services (MHS) is a critical factor. 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 decade, national plans and programmes in India have stressed the need for universal access to health care especially the maternal & child health services in rural area. Many studies have revealed low utilization of the health care services by different segments of the society for varying reasons. With each Medical college adopting three Primary Health Centres, it is expected that there will be an increase in the utilization of the health service.
Antenatal care (ANC) is a pivotal factor for safe motherhood. The primary aim of ANC is to achieve healthy mother and a healthy baby at the end of pregnancy. Mothers who have not received good quality ANC are found to be more at risk of having low birth weight babies and there is a clear association between infant mortality rate and l or poor quality ANC. Moreover, substantial reduction in perinatal mortality takes place even if the initial antenatal check- up is availed by women as late as the third trimester.
Antenatal visits may raise awareness about the need for care during delivery or give women and their families a familiarity with health facilities that enable women to seek care (Chauhan, 2012). It often presents the first contact opportunities for a pregnant woman to connect with health services, thus offering an entry point for integrated care, promoting healthy home practices, influencing care-seeking behaviors and linking women with pregnancy complications to a referral system thus impacting positively on maternal and fetal health (Bulatoo & Ross, 2000).
Moreover, ANC supports to apply the possible preventive and curative measures to manage the complications in time through various services viz. counseling on nutrition, birth preparedness, delivery care, post-partum care and family planning options after delivery. The first section presents background to current situation of ANC services utilization in Nepal followed by brief presentation of literature review. Third section describes methodology adopted in detail including type of data and analysis techniques.
The content and quality of antenatal care and the availability of effective referral with essential obstetric care are important for antenatal care to be effective. However many studies have revealed low utilization of antenatal health care services for varying reasons. A few studies show considerable improvement in utilization of antenatal care, but there is little evidence on the content and quality of antenatal care in these settings (Rani et al., 2008).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Demographic and Socioeconomic Factor Influencing Utilizing Maternal Health Services.
1.3 Statement of Problems
Investigation revealed that maternal mortality is a major global health problem particularly in low- and middle-income countries (LMIC), and the huge inequality between the high and the low-and middle-income countries remains a great sustainability concern. In sub-Saharan Africa, Nigeria continues to be one of the countries with the poorest maternal health outcomes with a mortality ratio of over 1000 per 100,000 live births in its Northern region. While there are many determinants of maternal mortality, low utilization of maternal health services (MHS) is a critical factor.
1.4 Aim and Objectives of Study
The aim of the study is to determine the Demographic and Socioeconomic Factor Influencing Utilizing Maternal Health Services in Some Rural Area in Warri-South Local Government Area. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the likelihood of utilization of ANC services in relation to women’s demographic, social and economic status in the study area,
- To study the contents and quality of antenatal care in the study area, and
- To investigate the factors influencing the utilization of antenatal health care services in the area under study.
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:
- Are there factors influencing the utilization of antenatal health care service in the area under study?
- What are the contents and quality of antenatal care in the study area?
- What is the likelihood of utilization of ANC services in relation to women’s demographic, social and economic status in the study area?
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 are no significant factors influencing the utilization of antenatal health care service in the area under study
- H1: There are significant factors influencing the utilization of antenatal health care service in the area under study
1.7 Significance of Study
This study will be of immense benefit to midwifery students and other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Demographic and Socioeconomic Factor Influencing Utilizing Maternal Health Services in Warri-South Local Government Area.
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.
- 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).