1.1 Introduction
Women's access to reproductive health care is essential components of the overall welfare that is offered to society. Until women have access to reproductive health care services, no society can be guaranteed to be healthy (Ujah, 2013). However, the government's capacity to provide women with the reproductive health care they require has been reduced due to several factors such as cost, sustainability, availability, accessibility, and availability. That being said, research has shown that cultural and economic factors are mostly to blame for the exacerbation of the reproductive health issue in the local government region (Tinuola, 2009).
This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.
1.2 Background of Study
Health workers have historically made significant contributions to the primary prevention of disease in both community and hospital settings, with a focus on front-line healthcare providers who are on hand to attend to patients' urgent medical needs, as stated by (Agyeponget al. 2001). 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).
The term health care utilization refers to the measurement or explanation of how people use services to prevent and treat health issues, maintain their health and well-being, or find out information about their current condition and prognosis (Cardasquillo, 2013). Utilizing health care services is referred to. A good way to define utilization is the amount or use of health services per population unit. Utilization in the context of health care is described as the consumption of services or supplies, such as the number of office visits an individual makes with a health care provider annually, the number of prescriptions filled, or the number of hospital days an individual stays.
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).
Factors impeding the enjoyment of these rights include inadequate or nonexistent laws and policies, systematic corruption, poor infrastructure, inadequate health services, and difficulty accessing qualified healthcare providers due to the division of duties among the state's three levels of government for health care provision (Ogundipe and Obinna, 2009). Because of this, reproductive health care in Nigeria is still provided in a typical manner similar to that of the majority of states in the country, where factors such as widespread poverty, illiteracy, ignorance, disease, low status for women, unrestricted sexual behaviour that contributes to a high rate of population growth, harmful traditional practices, and inadequate social amenities all work together to promote reproductive ill health (Lawrence, 2014).
According to Carrasquillo (2013), utilization is frequently expressed as the population denominator divided by the total number of services consumed during a certain period of time. is the ratio of those who are entitled to utilize a service to those who actually use it. According to Oladipo (2014), there are variations in the health condition of emerging nations based on indicators including maternal, newborn, and young child mortality. The study aims to explore the socio-economic aspects that influence rural residents' use of healthcare services, as enhancing the quality of healthcare services is crucial to increasing their utilization.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the impact of women's accessibility to health care during pregnancy.
1.3 Statement of Problems
Investigation showed that the health sector prefers to target its interventions within the health-care delivery system rather than in other areas that may be the root of the issue. There is a severe shortage in the distribution of healthcare facilities, making their availability a major issue. In Nigeria, the medical community faces significant obstacles in addressing various health-related issues. The first priority is to reverse the brain drain problem, which is now having a negative impact on Nigeria's national life in key sectors other than the health sector.
Women's reproductive health issues may be resolved by preventative measures. According to his opinion, policy makers and other stakeholders ought to be involved in providing women with information and services related to reproductive health as well as developing successful communication plans that will influence behaviour (Alison, 2002). Therefore, it is against the backdrop of this research that the study tends to examine how easily the women were able to get healthcare during their pregnancies.
1.4 Aim and Objectives of Study
The aim of the study is to analyze the Impact of Women's Accessibility to Health Care During Pregnancy. In achieving this aim, the following specific objectives were laid out as follows:
- To assess the influence of educational status on utilization of reproductive health care services among pregnant women;
- To examine the impact of reproductive health care service access on the health of pregnant women;
- To determine the adequacy of reproductive health care services provided to pregnant women; and
- To investigate the influence of attitude of health care personnel on utilization of reproductive health care services among pregnant women.
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:
- What is the influence of educational status on utilization of reproductive health care services among pregnant women?
- What is the impact of reproductive health care service access on the health of pregnant women?
- How adequate is reproductive health care services provided to pregnant women?
- What is the influence of attitude of health care personnel on utilization of reproductive health care services among pregnant women?
1.6 Significance of Study
The findings of this study would provide information on the adequacy or otherwise of health services provided to community residents with a view to improving the services. Also, the results of this study will aid policy makers in comprehending issues that hinder women from effectively using reproductive health care and in determining the best course of action.
Furthermore, it would give other scholars who are interested a foundation for their future studies. The results of this study will further our understanding of how healthcare services are provided and used.
1.7 Scope of Study
The scope of the research is focused on the impact of women's accessibility to health care during pregnancy. The study is utilized the Enugu State Teaching Hospital (ESUTH) in Nigeria as a case study.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- 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.
- 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).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.9 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.
