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Relationship between Attendance of ANC and labour Complications among Mothers who delivered at Fort Portal Regional referral Hospital

Juweria Mohamed

Faculty of Medicine and Dentistry Kampala International University Western Campus Uganda.

ABSTRACT

Appropriate antenatal care (ANC) is key for the health of the mother and child. Globally, approximately 515,000 women die from pregnancy-related complications each year. It has been estimated that 25 percent of maternal deaths occur during pregnancy, with variability between countries depending on the prevalence of unsafe abortion, violence, and disease in the area. This study focused on the relationship between attendance of ANC and gestational or labor complications among mothers who delivered at Fort Portal Regional Referral Hospital (FPRRH). A cross-sectional study was conducted whereby quantitative data was acquired using participant self-administered questionnaires, investigator administered questionnaires. A total of 323 mothers were randomly sampled from the population using the convenience sampling technique. Results are depicted in 95% Confidence Intervals, Odd Ratios (OR), and P-values; all calculated using Binary Logistic Regression with Pearson’s correlation in the Statistical Package for Social Sciences. Graphical representation was done by Microsoft Excel Software. A total of 323 mothers were studied with a response rate of 91.02%. Results based on 294 participants show that 70(23.7%) of the mothers studied were in the age range of 15-25 years,  majorly 170(57.8%) were 26-35 years, 54(18.5%) were 36-45 years; of these 33(11.1%) were single, 171(58.2%) were married, 55(18.6%) were separated and 36(12 %) were widows; 39(13.2%) attained primary level of education, 117(39.8%) secondary, 88(29.8%) tertiary, and  51(17.2%) were university graduates; 40(13.5%) were casual laborers, majority 208(70.8%) self- employed, and 46(15.7%) were civil servants. The study showed that the overall attendance of ANC among mothers in Fort Portal FPRRRH was low. This trend was shown to be     significantly associated with a number of factors. Intensive health education and awareness campaigns on the importance of   ANC should be done to equip mothers with the knowledge so as to reduce the burden of pregnancy-related complications. More effort must be applied to spreading awareness about proper health service seeking by mothers.

Keywords: Antenatal care, Pregnancy, Maternal mortality, Labour, Health facilities.

INTRODUCTION

Appropriate antenatal care (ANC) is key for the health of mother and child [1]. Globally, approximately 515,000 women die from pregnancy-related complications each year. 2008 data from the United Nations Development Programme (UNDP) suggest 250 (maternal deaths per 100,000 live births) whereas 2006 data from the Demographic Health Survey (DHS), indicate a much higher value of 733 [2]. It has been estimated that 25 percent of maternal deaths occur during pregnancy, with variability between countries depending on the prevalence of unsafe abortion, violence, and disease in the area [3]. Between a third and a half of maternal deaths are due to causes such as hypertension (pre-eclampsia and eclampsia) and antepartum hemorrhage, which are directly related to inadequate care during pregnancy [4], [5]. Certain pre-existing conditions become more severe during pregnancy [6]. Malaria, HIV/AIDS, anemia, and malnutrition are associated with increased maternal and newborn complications as well as death [7]-[10]. The World Health Organization (WHO) also envisions a world where “every pregnant woman and   newborn receives quality care throughout their pregnancy, childbirth, and postnatal periods” [11]. The basic materialization of this vision is only through the efforts of a well-utilized antenatal care service, as the WHO has demonstrated a positive relationship between ANC service utilization and pregnancy outcomes [12]. Antenatal care is a type of health service upkeep provided by skilled health professionals to pregnant women so as to ensure the best health condition of both the mother and the unborn baby throughout the pregnancy period [13], [14]. This service is composed of risk identification, prevention and management of pregnancy-related or concurrent conditions, and health education and health promotion with essential interventions such as early identification and management of obstetric complications, identification and management of sexually transmitted infections (HIV/AIDS, syphilis and others), tetanus toxoid immunization, and intermittent preventive treatment for malaria during pregnancy [15], [16]. Regardless of the fact that about half of pregnant women globally received at least one prenatal care in the year 2013, most pregnant women persistently miss these indispensable services provided by antenatal care [3]. Kuhnt and Vollmer [17] found in their research that at least one ANC visit is associated with 1.04% points reduced probability of neonatal mortality and 1.07% points lower probability of infant mortality. Moreover, it was found in the same study that, at least one ANC visit is associated with 3.82% points reduced probability of giving birth to a low birth weight baby, 4.11% and 3.26% points reduced stunting and underweight probability respectively. A conclusion was therefore drawn from the same study that, currently, the existing and accessed ANC services in most low-income and middle-income countries are directly associated with improved birth outcomes and long-term reduction of child mortality and malnourishment [17].

Complications during pregnancy, mortality, and other pregnancy-related disorders remain inadmissible high on the global front claiming millions of women’s and infants’ life [12]. It is a recommendation by the world health organization that, all pregnant women should have at least four antenatal visits throughout their pregnancy period [11]. Globally, while 86 percent of pregnant women access antenatal care with skilled health personnel at least once, only  three in five (62 percent) receives at least four antenatal visits [11] which is even worse in countries with high maternal mortality rates such as sub-Saharan Africa (51.9%) and least developed countries including Uganda (45.8%) [18]. Despite this effort by the government of Uganda to minimize maternal mortality, facility-based deliveries continue to be low. This is attributed to the poor quality of antenatal care which prevents pregnant women from giving birth at health facilities [19]. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa [20]. Women in rural areas of Uganda are two times less likely to attend ANC than urban women [20]. Most women in Uganda have   registered late ANC attendance, average at 5.5 months of pregnancy, and do not complete the required four visits [20]. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. It is therefore important to investigate the factors associated with ANC utilization to help with the implementation of necessary policies which can help deal with pregnancy complications and help produce healthy babies. Thus, this study is set to identify the relationship between ANC attendance and labor complications among mothers who delivered at Fort Portal Regional Referral Hospital.

CONCLUSION

The overall attendance of ANC among mothers who delivered in Fort Portal Regional Referral Hospital is low as depicted by Figure 3 according to the number of mothers seeking care. Intensive health education and awareness campaigns on the importance of ANC should be done to equip mothers with the knowledge so as to reduce the burden of pregnancy-related complications.

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CITE AS: Juweria Mohamed (2023). Relationship between Attendance of ANC and labour Complications among Mothers who delivered at Fort Portal Regional referral Hospital. IDOSR JOURNAL OF SCIENTIFIC RESEARCH 8(3) 1-13. https://doi.org/10.59298/IDOSR JSR /2023/00.1.6000

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