1.0 Introduction
1.1 Background of Study
In the early 1900s, maternal mortality rates were alarmingly high in many parts of the world, including in more developed countries. Efforts to reduce maternal mortality initially focused on improving hygiene and midwifery practices. The introduction of prenatal care in the 1920s and 1930s marked a significant advancement, as it helped to identify and manage pregnancy-related complications early. The modern safe motherhood movement began in earnest in 1987 with the launch of the Safe Motherhood Initiative at an international conference in Nairobi, Kenya. This initiative was a collaborative effort by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), and the World Bank. The primary goal was to reduce maternal mortality by 50% by the year 2000 (Rosenfield, Maine, & Freedman, 2006).
In 2000, the adoption of the Millennium Development Goals (MDGs) by the United Nations brought renewed focus to maternal health. Goal 5 aimed to improve maternal health, with specific targets to reduce the maternal mortality ratio by three-quarters and achieve universal access to reproductive health by 2015. This period saw significant investments in maternal health programs and a greater emphasis on measuring progress through data collection and reporting (United Nations, 2015).
According to Mandara and Otubu (2007), safe motherhood means ensuring that women’s receive the care they need to be and health through the pregnancy. Motherhood is a beautiful and joyous experience to a woman the health of the mother during pregnancy is important to give birth to a healthy baby (Mandara and Otubu, 2007). Safe motherhood is a crucial aspect of public health, aiming to ensure that women receive the care they need to be safe and healthy throughout pregnancy and childbirth. The concept encompasses a wide range of practices and interventions designed to reduce maternal morbidity and mortality. These include prenatal care, skilled birth attendance, emergency obstetric care, postpartum care, and access to family planning services.
Maternal health remains a critical public health concern worldwide, with significant implications for the health and well-being of both mothers and children. Despite global efforts to improve maternal health outcomes, maternal mortality remains unacceptably high, particularly in low- and middle-income countries. According to the World Health Organization (WHO), approximately 295,000 women died during and following pregnancy and childbirth in 2017, with the vast majority of these deaths occurring in resource-limited settings (World Health Organization, 2020).
Safe motherhood is a multifaceted approach aimed at ensuring that women receive the necessary care to safely go through pregnancy and childbirth. Key components of safe motherhood include antenatal care, skilled birth attendance, emergency obstetric care, and postpartum care. Additionally, access to family planning services is essential for preventing unintended pregnancies and reducing maternal mortality.
Previous studies have highlighted that inadequate knowledge and poor practices are significant contributors to adverse maternal outcomes. For instance, a study conducted in rural Ethiopia found that only 32% of women had adequate knowledge of key safe motherhood practices, and just 18% received the recommended four antenatal care visits (Basha, 2019). Socioeconomic factors, cultural beliefs, and limited access to healthcare services often hinder the adoption of safe motherhood practices. In many communities, traditional practices and a lack of education about maternal health continue to pose challenges. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to assess the knowledge and practice of safe motherhood among women of reproductive age.
1.2 Statement of Problems
Investigation revealed that many women of reproductive age lack adequate knowledge about safe motherhood practices. This includes understanding the importance of prenatal care, recognizing danger signs during pregnancy, and knowing when and how to seek emergency obstetric care. For example, a study in rural Ethiopia revealed that only 32% of women had sufficient knowledge of essential safe motherhood practices (Basha, 2019). Also, even when women are aware of safe motherhood practices, access to quality healthcare services is often limited. This includes a lack of skilled birth attendants, insufficient emergency obstetric care facilities, and inadequate postpartum care. These gaps in service provision are exacerbated by socio-economic barriers, geographical constraints, and cultural factors.
Furthermore, effective family planning is a critical component of safe motherhood, helping to prevent unintended pregnancies and reduce maternal mortality. However, utilization of family planning services remains low in many regions, often due to lack of awareness, cultural opposition, and limited availability of contraceptives (Cleland, Conde-Agudelo, Peterson, Ross, & Tsui, 2012). Hence, it is against this backdrop that this study aims to improve the knowledge and practice of safe motherhood among women of reproductive age.
1.3 Aim and Objectives of Study
The aim of the study is to assess the knowledge and practice of safe motherhood among women of reproductive age in Calabar South Local Government Area. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the level of knowledge among women of reproductive age regarding safe motherhood practices such as prenatal care, and skilled birth attendance;
- To examine the socio-economic factors influencing the knowledge and practice of safe motherhood among women of reproductive age;
- To investigate the barriers that prevent women of reproductive age from accessing and utilizing maternal health services effectively; and
- To assess the perceptions and experiences of healthcare providers regarding the challenges and opportunities in promoting safe motherhood practices among women of reproductive age.
1.4 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 level of knowledge among women of reproductive age regarding safe motherhood practices such as prenatal care, skilled birth attendance, and postpartum care?
- How do socio-economic factors influence the knowledge and practice of safe motherhood among women of reproductive age?
- What are the barriers that prevent women of reproductive age from accessing and utilizing maternal health services effectively?
- What are the perceptions and experiences of healthcare providers regarding the challenges and opportunities in promoting safe motherhood practices among women of reproductive age?
1.5 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: Women’s level of education is negatively associated with their knowledge of safe motherhood practices, indicating that higher educational attainment leads to greater awareness and understanding of maternal healthcare needs
- H1: Women’s level of education is positively associated with their knowledge of safe motherhood practices, indicating that higher educational attainment leads to greater awareness and understanding of maternal healthcare needs
Hypothesis Two
- H0: Socioeconomic status significantly does not influence the utilization of safe motherhood practices among women of reproductive age, with higher socioeconomic status correlating positively with increased access to and utilization of maternal healthcare services
- H1: Socioeconomic status significantly influences the utilization of safe motherhood practices among women of reproductive age, with higher socioeconomic status correlating positively with increased access to and utilization of maternal healthcare services
1.6 Significance of Study
The significance of the study "Knowledge and Practice of Safe Motherhood Among Women of Reproductive Age" will be relevant to the following stakeholders:
- For Women of Reproductive Age, the study provides valuable insights into their current understanding and practices related to safe motherhood. By identifying knowledge gaps and barriers to accessing maternal health services, the study can help develop targeted educational programs and interventions, ultimately empowering women to make informed decisions about their health and well-being.
- For Healthcare Providers, the findings can inform the development and implementation of more effective training programs and resources to improve the quality of care provided to pregnant women and new mothers. By understanding the challenges faced by women, healthcare providers can tailor their services to better meet the needs of their patients, thereby enhancing maternal health outcomes.
- For Policy Makers, the study offers critical data that can guide the formulation and implementation of policies aimed at improving maternal health. The insights gained can help in designing policies that address the socio-economic and cultural barriers to accessing maternal health services, ensuring that more women benefit from safe motherhood practices.
- For Community Leaders and Organizations, the study highlights the importance of community involvement in promoting safe motherhood practices. By raising awareness and mobilizing community resources, leaders and organizations can play a pivotal role in supporting women and encouraging positive health behaviors within their communities.
- For Researchers and Academics, the study contributes to the existing body of knowledge on maternal health, providing a basis for further research and exploration. It offers a comprehensive understanding of the factors influencing safe motherhood practices and opens avenues for future studies aimed at developing innovative solutions to improve maternal health outcomes.
1.7 Scope of the Study
The scope of this research is focused on the knowledge and practice of safe motherhood among women of reproductive age using Calabar South Local Government Area as a case study.
1.8 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.
- 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.
- 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).
1.9 Definition of Terms
Women of Reproductive Age:
This term typically refers to women aged 15 to 49 years, the age range during which women are biologically capable of conceiving and bearing children (Centers for Disease Control and Prevention, 2021).
Safe Motherhood:
Safe motherhood refers to the initiatives and practices aimed at ensuring that women receive the necessary care before, during, and after pregnancy and childbirth to prevent maternal and infant mortality and morbidity. It encompasses a wide range of interventions, including prenatal care, skilled birth attendance, emergency obstetric care, and postpartum care (World Health Organization, 2020).
Prenatal Care:
Also known as antenatal care, prenatal care involves the regular medical and health check-ups, including screenings and educational services, that a woman receives during her pregnancy to ensure the health of both the mother and the developing fetus. It is crucial for monitoring pregnancy progress and identifying any potential complications early (American College of Obstetricians and Gynecologists, 2020).
Skilled Birth Attendance:
This refers to the presence of a trained and competent health professional, such as a midwife, nurse, or doctor, during childbirth to manage the delivery and handle any complications that may arise. Skilled birth attendance is essential for ensuring safe delivery and reducing maternal and neonatal mortality (World Health Organization, 2018).
Emergency Obstetric Care (EmOC):
Emergency obstetric care involves critical medical interventions that address complications during pregnancy and childbirth, such as severe bleeding, obstructed labor, pre-eclampsia, and infections (United Nations Population Fund, 2021).
Postpartum Care:
Postpartum care refers to the care provided to the mother and newborn immediately after birth and during the first six weeks following delivery. This care includes monitoring the health of the mother and baby, providing breastfeeding support, and addressing any post-delivery complications (American College of Obstetricians and Gynecologists, 2018).
Family Planning:
Family planning involves the use of contraceptive methods and the provision of educational services to help individuals and couples plan and space pregnancies. Effective family planning can prevent unintended pregnancies and reduce the risk of complications associated with closely spaced or high-risk pregnancies (Cleland, Conde-Agudelo, Peterson, Ross, & Tsui, 2012).
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