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1.1    Background to the Study

Antenatal care is the  key  entry point for a pregnant women to   receive a broad  range of health promotion and preventive health services, including nutritional support,  prevention and treatment of anaemia,  prevention, detection and treatment of malaria, tuberculosis  and sexually transmitted infection (STIs/HIV/AIDS) particular prevention of HIV transmission from mother to child and tetanus toxoid immunization (WHO, 2013). Antenatal care is an opportunity to promote the benefits of skilled attendance at birth and to encourage women to seek post partum care for themselves and their unborn. It is also an ideal time to counsel women about the benefits of child spacing. Antenatal care is an essential link in the household to hospital care continuum. It is an intervention that can be provided at both the household and peripheral facility levels assure the link to higher levels of care when needed (WHO, 2013). In the household to hospital continuum of care, the community is mobilized as a link between families and the care they need. In this model, community health workers (CHWS) and skilled attendants help women and their families become active participants in maintain normal  pregnancy and in seeking additional care seeking additional care when required (USAID  ACCESS, 2013). Thus certain components of antenatal care can be provided as part of home based practices and care, while basic antenatal   care services are provided in peripheral facilities by skilled attendants. The community, women and their families CHWS and skilled attendants share the responsibility to help improve care seeking behavior and access to antenatal care. Result of community-based behavior intervention in four countries  demonstrated an increase in antenatal care attendants in all four countries an increase in child birth with a skilled provider, and an increase in the  proportion of  women who made arrangement for transportation to the  health care facility in case of an obstetric emergency. The intervention included creating a locally appropriate mass media campaign to help define safe motherhood as a broad social issue established a community mobilization system and ensuring high quality clinical services and skills (USAID Access, 2013).

Skilled attendants and CHWS work together to provide antenatal care services counseling and health education for  pregnant women and their families. Trained CHWS can provide health education on danger sign and where to go if there is an emergency, as well as on care seeking and preventive practices e.g provision of insecticide treated nets9, micro nutrients supplementation and counseling  about nutrition  and safer sex.

They can also advise women and their families on how to prepare for birth and potential complications and promote the benefits  of receiving antenatal care and having   a skilled  provider attend the  birth, whether at home or in the facility (USAID   Access, 2013).

Traditional antenatal care uses a risk approach to classify women  are more likely to   experience complications and assumes that more visits mean better outcomes for mother  and baby. However, many women who have  high risk   factors will  not  develop complications while women  without risk factors may do so (USAID Access, 2013). Using  a risk approach  with its  more  frequent visits, thereby  does not necessarily  improve pregnancy outcomes. Furthermore, when  antenatal   care is planed using risk  approach, scare health  care resources may be devoted  to unnecessary care for “high-risk” women who may never develop complications and “low risk” women may not receive essential care on may  be unprepared  to  recognize or  respond to sign of complications (USAID Access, 2013). Also frequent visit  are often  logistically and financially impossible for women   to manage and  are  a burden on the health care system (USAID Access,  2013).

1.2      Statement of the Problem

All pregnant women are expected to attend an approve health facility because care of the children begins from the first trimester of pregnancy. Nigeria is still passing through various stages of development, many women still deliver their babies at home, without attending Antenatal Clinic, while some pregnant mothers visit the clinic only for them to have the card and for emergency reason (Combs, 2013).

The role of health workers in the management of pregnant mothers’ is very important for ensuring that clients receive appropriate care from the state of conception, birth and post partum. Unfortunately, today many women see health workers role differently being hostile, in confident, unnecessary delay, aggressive and not competent enough (Onasoga, 2012).

Globally, the implementation of focused antenatal care is not fully attainable as a result of lack of political will on policy change and implementation of favorable policies on the issue of maternal and neonatal morbidity/mortality.

In Nigeria, long distances in pregnancy and resulting maternal and connection are bad. It takes time and money to travel to the health care facility for a checkup or in  case of emergency, thus  endangering  the life of the mother and baby.  This factor has continued to encourage the utilization of quacks and poorly trained traditional   birth   attendances who reside in the community and who enjoy the confidence of the people  (Nylander and Adedule, 2014).

1.3     Significance of the Study

          The following benefit from the study

-         To the Pregnant Women

It acts as a tool in detecting early, the problems associated with pregnancy and delivery and prompt treatments before it results in complications.

It alleviates the complication resulting from maternal and child mortality rate in Nigeria especially in Kaduna state Birnin Gwari Local Government.

The pregnant women are able to know what to do at each stage of pregnancy and the appropriate time for visit.

-         To the Nurses/Midwives

The research study assists in planning and educating pregnant women attending Focused Antenatal care in Jibril Mai Gwari Memorial Hospital Birnin Gwari.

It helps the nurses to carryout intensive mobilization for the communities on the benefits of focused Antenatal Care to the Mothers, family and community at large.

-         It helps the health care provider to understand and realize their weakness and the strategies in rendering services that will improve the utilization of Focused Antenatal Care thereby improving the chances of its utilization by pregnant women

-         To the Researcher

It acts as a  guide for further studies

-         To the Community

It will create awareness to the member of the community and the public on the important of Focused Antenatal Care and early of detection of disease  

1.5     Broad Objective of the Study

This study aimed at the Appraisal of focused Ante-natal care on management of pregnant women in Jibril Mai Gwan 1 Memorial Hospital, Birnin Gwari, and Kaduna.

1.6     Specific Objective

i.                   To know the attitude of pregnant women towards focused Ante-natal care.

ii.                 To identify the factors that hinder pregnant women from attending focused Ante-natal care.

iii.              To determine the level of awareness of pregnant women toward focused antenatal care.

1.7     Research Questions

The study will be guided by the following research questions:-

i.                   What is the attitude of pregnant mothers towards focused ante-natal care?

ii.       What is the factors that hinder pregnant women from attending

         focused Ante-natal care?

iii.      What is the level of awareness of pregnant women towards focused Antenatal care?

1.8     Scope of the Study

The study covers the Appraisal of focused Ante-natal care on management of pregnant women in Jibril Mai Gwan 1 Memorial Hospital, Birnin Gwari, Kaduna.

1.9     Operational Definition of Terms

a. ANC: Antenatal care is the supervision, advice and intervention given to a pregnant woman by a health care provider.  

b. Skilled Attendant: According to a statement by WHO, the term “skilled attendant” refers to an accredited health professional such as midwife, nurse or doctor who has been educated and trained to proficiency in the skill needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postal period, and in the identification, management or referral or complication in women and new born. Traditional birth attendants either trained or not, are excluded from the category of skilled health workers.

          c. MNH: Maternal and Neonatal Health.

          d. TBA: Traditional Birth Attendants.

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