CHAPTER
ONE
INTRODUCTION
1.1 Background of the study
Primary
health care as a strategy in health care delivery has brought maternal and
health care services nearer to the people even to the remotest areas. The
increased interest in maternal health care services shown by National agencies
in recent years due to health risks associated with the biological process of
reproduction which affects naturally all women at various stages of their lives
and vulnerability of children to childhood diseases and other illness such as
malaria, diarrheal diseases and acute respiratory tract infections etc (Wallace
2007).
Pregnancy
and child birth are normally healthy events requiring minimum intervention by
health care providers. Inspits of this however, chronic ill health, life
threatening complications associated with pregnancy, childbirth and lactation
are major causes of morbidity and mortality among women in developing countries
(Dagu 2004). The morbidity and mortality rate among children and women is
higher in the rural areas than the urban. The data of multiple indicator
cluster survey (MICS) and that of National Demographic health survey (2003)
shows that Nigeria as failed by large margin to attain the goals of reduction
of infant. Mortality rate (IMR), set in the National Programme of Action for
survival protection and development of the Nigerian child adopted by the
Federal Government in 1992. With the rural areas far worst than the urban
areas. The multiple indicator cluster survey of 2003 rate of 704 per 1000,000.
Live births, this is twice as high in the rural areas (828 per 1,00,000 Live
births (Unicef 2001).
UNICEF
in Nation Demographic Health Survey (2003) observed that 37 percent of
expectant mothers do not make any ante-nata visit and also do not receive any
tetanus toxoid vaccination. One of the main target of governments is to achieve
health for all by the year 2000 and beyond.
WHO
(2001) stressed that health is a fundamental human right and should be provided
in such a way that individual in the communities will have the right to health
care where they live and work.
Unicef
(2001) stated that the high levels of mortality in young children are mainly
due to illness that can be prevented or can be treated. These illness include
malaria, diarrhoea and other vaccine preventable diseases, and acate
respiratory tract infections.
Namboze
(2005) asserted that women in Nigeria suffers premature loss of life as a
result of inadequate provision of health facilities ignorance and cultural
taboos. According to Unicef’s rating, Nigeria has one of the highest mortality
rate in sub Sahara Africa. Maternal mortality rate is about 704 percent per
100,000. As women’s health suffer so does the health of children with infant
mortality rate at 105 per 1,000 live birth while under five mortality rate was
placed at 178 per 1,000 (Unicef).
Okafor
and Rizutto (2004) observed that rural dwellers in Nigeria under-utilize
maternal and child health care services not out of choice but as a result of
general factors such as distance, cost of care, educational level of mothers,
attitude of health care providers and cultural beliefs etc.
Data
from earlier studies also showed that optimum utilization of maternal health
care services had become a major problems in Nigeria in general and in rural
areas in particular. A study by Nginya (2006) show that only 22.5 percent and
31.7 percent of women respectively made use of ante-natal care service in
Nigeria. Maternal health care service has suffered serious neglect from the
past administrations in Nigeria at the federal, state and local government level.
According
to Curr-Hill, Place and Posnett (2007) primary Health care is meant to bring
health care services closer to the rural areas, His meant to also achieve a
level of health that will enable all Nigerians to achieve socially and
economically productive lives. This strategy was adopted to improve health
status of the populace of which Nigeria like other countries has committed to
achieve (FMOH 2004). This research is therefore carried out to investigate
those indices affecting utilization of maternal health care services in
AKpabuyo local Government Area of Cross River State.
1.2 Statement of the problem
For
Akpabuyo maternity and health care services access is uneven and unstable. Also
lack of proper education and training of the maternal health care workers most
especially the traditional Birth Attendance contribute to low patronage by the
women living in Akpabuyo Local Government Area, lack of availability and
accessibility of services. Particularly in rural and remote communities
contributes to the negative attitude of women towards the utilization of
maternal health care services.
The
women living in Akpabuyo are not fully informed about the range of available
maternity services, insufficient information to make informed decisions about
an appropriate birth setting and about their preferred type of and subsequent
care, as well as to know about the risk benefit and indications for those
choices (Basu 2007). According to Basu (2007) there are several factors that
affect the utilization of maternal health care services in Nigeria, such as
cultural beliefs, distance to health facilities, cost, unavailability of drugs
lack of education etc. has made it difficult for women to utilize maternal
health care service in Akpabuyo. It seems logical therefore to hypothesize that
given the slightest constraints, maternal and child health care services in
health facilities in Akpabuyo.
Therefore,
the research wish to investigate these factors affecting utilization of
maternal health care services in Akpabuyo local Government Area of C
1.3 Purpose of the study
The general objective of the study is to
investigate the factors influencing the attitude of women towards the
utilization of maternal health care services in Akpabuyo Local Government Area.
Specifically the study sought to find out
whether:
1. Mothers’
level of education affects their utilization of maternal health care services
in Akpabuyo Local Government Area.
2. Distance to health facilities affect the utilization of maternal
health care services in Akpabuyo Local Government Area.
3. The attitude of health care providers affacts the utilization of
maternal health care services in Akpabuyo Local Government Area.
4. The cultural beliefs of the people affects the utilization of
maternal health care services in Akpabuyo Local Government Area.
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