1.1 Introduction
Health seeking behaviour refers to all those things humans do to prevent diseases and detect diseases in their asymptomatic stages. In contrast, illness behaviour refers to all those activities designed to recognize and explain symptoms felt by an ill person and sick role behaviour refers to all those activities designed to cure diseases and restore health after a diagnoses has been made (Kraszewski, 2009). Health seeking behavior is a multi-dimensional concept. The definition of this concept varies depending on the attributes used and the context emphasized. In a broader sense, it refers the action and practice undertaken by an individual to be healthy and remain free from the occurrences of disease (Sen, 2012). Health seeking behavior and health care seeking behavior are not one and the same.
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
Since maternal health care relies on the entire health system of a country, its outcomes including health-seeking behavior can be traced from the way health systems operate (Parkhurst et al., 2005). The health system includes the human resources, organization of maternal health services which dwells on the availability of both private and public sectors, and reforms in the health sector (Graham, 2002). These are in general, what Nigeria’s maternal health service is dependent on, and have various implications for maternal health-seeking behavior. This section of the paper discusses these elements in the health system.
Maternal mortality ratio in sub-Saharan Africa alone has reduced by only 1.6% per annum since 1990 while other regions like the East Asia and the Pacific regions have seen on average an annual decline of 4.5%. It is expected that a 5.4% decline per annum is required to achieve the millennium development targets in the sub-Saharan African region (Wagstaff et al., 2004).
In Nigeria, women are said to be mothers of all, because they are usually the bearer of pregnancy, that is, the role of child bearing is traditionally assigned to them (Ogunjuyigbe, 2000). Thus pregnancy is one of the most important events in the life of every woman and it is also a dynamic process in which a woman’s risk status can change at any point in time (WHO, 2000). Hence, pregnant women can be said to be at risk of developing some health problems such as anaemia, fever, malaria, excessive fatigue, diarrhoea, reproductive tract infections, sexually transmitted infections, headache, backache, swelling, cramps (Chamberlain, 2001).
Furthermore, their health seeking behaviour can be influenced by some factors such as cultural factors (which includes low status of women in the sense that they take authority from their husbands before taking/seeking medical aid), social factors like sex, age, educational level, marital status, occupation. Societal factors may include growth and equity, peer pressure, governance(which include overall approach of government toward health of the state), socioeconomic factors like standard of living, economic status/income, religion, cost of care, the type and severity of illness, geographical factors such as bad roads, weather/climatic changes, physical factors like the attitudes of health care personnel, long waiting at the healthcare centres/time wasting, standards of equipment, standard and availability of essential drugs, cost of care not equal to services rendered, interpersonal relationship between the health care team (Borras, 2004).
It may seem right to discuss maternal health outcomes based on only how maternal health service is organized or on how it is financed. But such discussions may lead to a one-sided finding, if not biased outcomes. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Maternal Health Seeking Behaviors and Pregnancy Outcome.
1.3 Statement of Problems
Investigation revealed that in recent years, health promotion programmes worldwide have been premised on the idea that providing knowledge about causes of ill health, choices and health care available. This had gone a long way towards promoting a change in individual behaviours towards more beneficial health seeking behaviours.
However, owing to the difference in people’s opinion on where and when to seek health care services and also from the review of available literatures, it shows that no study has been carried out to determine the health seeking behaviour amongst pregnant women attending antenatal clinic in health centres in Enugu State, especially in Nnewi North. Thus the researchers decided to embark on this study
1.4 Aim and Objectives of Study
The aim of the study is to scrutinize the Maternal Health Seeking Behaviors and Pregnancy Outcome. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the types of maternal health problems experienced by pregnant women,
- To ascertain their opinions towards the causes of their maternal health problems,
- To identify their reasons of choosing those places for maternal health care,
- To determine their opinion of suitable places to seek for maternal health care, and
- To find out the factors that influences their maternal health seeking behavior and pregnancy outcome.
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 that influence their maternal health seeking behavior and pregnancy outcome?
- What are the opinions towards the causes of their maternal health problems?
- What are the reasons of choosing those places for maternal health care?
- What are the opinions of suitable places to seek for maternal health care?
- What are the types of maternal health problems experienced by pregnant women?
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 that influences their maternal health seeking behavior and pregnancy outcome in Enugu State PHC
- H1: There are significant factors that influences their maternal health seeking behavior and pregnancy outcome in Enugu State PHC
1.7 Significance of Study
The study will be beneficial in the following ways:
- The pregnant women, as this will reveal their actual health seeking behaviour, such that they can be adequately be motivated and encouraged to develop better health seeking behaviours for their survival
- The family will also benefit as complications in pregnancy affect not only the woman, but also the family, bringing sorrow, thus the need for a good health seeking behaviour
- The community will also benefit as complications in pregnancy affect her and can lead to death of the pregnant woman, which will render the older children of the woman motherless and the husband, a widower. This affects the community negatively and depletes her economically as well.
- The policy makers will benefit from this as it will help them to plan effectively on how to combat the avoidable factors that militate against good health seeking behaviours amongst these women, such as reducing the cost of assessing health care services
- The health workers will also benefit as this will help them to effectively carryout campaign and actions on promoting good health seeking behaviour among these women through health education and rendering proper antenatal care services to them.
This study will also be of immense benefit to 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 Maternal Health Seeking Behaviors and Pregnancy Outcome in Enugu State Primary Health Care (PHC) Facility.
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).
