Öz
Background: Utilization of Antenatal Care (ANC) and skilled assistance during delivery are required to reduce maternal mortality and morbidity. Lack of skilled care during pregnancy and delivery is associated with poor pregnancy and delivery outcomes. The facility chosen for antenatal care and delivery determines whether women receive care from skilled or unskilled personnel. More information is needed on facility preferences of Nigerian women for ANC. This study was therefore conducted to assess antenatal care utilization, choice of facility for antenatal care and delivery among women in an urban community in Ibadan, Nigeria.
Methods: This was a cross-sectional study. A two-stage cluster sampling technique was used to select 351 women in Yemetu area. A pretested semi-structured questionnaire was used to obtain information on socio-demographic characteristics, antenatal care component, facility chosen for antenatal care and delivery, as well as the reasons for utilizing these facilities. Private and government-owned health facilities were classified as orthodox facilities while mission homes and facilities run by traditional birth attendants were classified as informal facilities.
Results: The mean age of respondents was 28.8 ± 5.6 years. 81.5% had at least secondary education. Sixty-two (17.7%) of respondents chose informal facilities for antenatal care and 76 (21.7%) delivered in informal facilities. Good component of antenatal care was received by 93.8% of women in orthodox facilities compared to 74.2% in informal facilities (p= 0.001). Respondents’ educational attainment was the single predictor of choice of informal facilities for antenatal care (OR=2.6; 95%CI= 1.4 - 4.9). The predictors of the choice of informal facilities for delivery were respondents who did not have antenatal care with skilled personnel at least once (OR=252.4; 95%CI= 78.2 – 817.9), and those who did not have someone to take them to the hospital during labour (OR= 4.38; 95%CI= 1.6 – 12.3).
Conclusion: There is a need to promote utilization of orthodox facilities for antenatal care especially among women of lower educational status.
Keywords: Antenatal care utilization, Antenatal care components, Informal health facilities
Résumé
Contexte: L’utilisation des soins prénatals et une assistance qualifiée lors de l’accouchement sont nécessaires pour réduire la mortalité et la morbidité maternelles. Le manque de soins qualifiés pendant la grossesse et l’accouchement est associé à de piètres résultats en termes de grossesse et d’accouchement. L’établissement choisi pour les soins prénatals et l’accouchement détermine si les femmes reçoivent les soins d’un personnel qualifié ou non qualifié. Des informations supplémentaires sont nécessaires sur les préférences des femmes nigérianes en matière d’établissement pour les soins prénatals. Cette étude a donc été menée pour évaluer l’ utilisation des soins prénatals , le choix de l’établissement pour les soins prénatals et l’accouchement chez les femmes d’une communauté urbaine d’Ibadan, au Nigéria.
Méthodes: Il s’agissait d’une étude transversale. Une technique d’échantillonnage en grappes en deux étapes a été utilisée pour sélectionner 351 foyers de femmes dans la région de Yemetu. Un questionnaire semi-structuré prétesté a été utilisé pour obtenir des informations sur les caractéristiques sociodémographiques, la composante de soins prénatals, l’ établissement choisi pour les soins prénatals et l’accouchement, ainsi que les raisons de l’utilisation de ces établissements. Les établissements de santé privés et appartenant à l’État ont été classés entant qu’établissements orthodoxes, tandis que les maisons de mission et les établissements gérés par des accoucheuses traditionnelles ont été classés entant qu’établissements informels.
Résultats: L’âge moyen des répondants était de 28,8 ± 5,6 ans. 81,5% avaient au moins une éducation secondaire. Soixante-deux (17,7%) des répondants ont choisi des établissements informels pour les soins prénatals et 76 (21,7%) ont accouché dans des établissements informels. Une bonne composante de soins prénatals a été reçu par 93,8% des femmes fréquentant les structures orthodoxes, par rapport à 74,2% dans les structures informelles (p = 0,001). Le niveau de scolarité du répondant était l’unique facteur prédictif du choix d’ un établissement informel pour les soins prénatals (OR = 2,6; IC à 95% = 1,4 à 4,9). Les prédicteurs du choix des structures informelles pour l’accouchement étaient les répondants qui n’avaient pas eu de soins prénatals avec du personnel qualifié aumoins une fois (OR = 252,4 ; IC 95% = 78,2 -817,9), et ceux qui n’avaient personne pour les emmener à l’hôpital au moment delabeur(OR = 4,38 ; IC 95% = 1,6 -12,3).
Conclusion: Il est nécessaire de promouvoir l’utilisation des services orthodoxes pour les soins prénatals, en particulier chez les femmes moins scolarisées.
Mots-clés: Utilisation des soins prénatals, Composants des soins prénatals, Établissements de santé informels
Correspondence: Dr. Mary O. Balogun, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria. Email: mobalogun2004@yahoo.com
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