ANTENATAL HEALTH SEEKING BEHAVIOUR AMONG PREGNANT WOMEN IN URBAN SLUMS OF IBADAN SOUTH EAST LOCAL GOVERNMENT AREA, NIGERIA

Abstract

Antenatal care (ANC) service provides pregnant women the opportunity to receive proper maternal health care services during pregnancy. Under-utilization of these services, especially among urban slum population is one of the reasons for high maternal mortality in Nigeria. However, studies focusing on women attending ANC services have not specifically considered health seeking behaviour among pregnant women living in urban slums. This study was designed to assess antenatal care health seeking behaviour among pregnant women living in urban slums of Ibadan South-East Local Government Area (IBSELGA) Oyo State, Nigeria. This study was cross-sectional in design with a four-stage random sampling technique which was used to select 540 respondents from 7 wards, 14 slums communities which were selected using simple random sampling and 540 respondents in the LGA. A pretested semi-structured interviewer-administered questionnaire which consisted of 28-point knowledge scale, questions relating to ANC health seeking, behaviour and factors influencing utilization of ANC was used for data collection. Knowledge score of ≤14 and >14 were rated as poor and good respectively. Six Focus Group Discussions (FGDs) were used to collect qualitative data. Quantitative data were analysed using descriptive statistics, Chi-square and logistic regression tests at 5% level of significance, while qualitative data were analysed using thematic approach. Age of respondents was 27.4±6.0 years. 96.3% were Yoruba and 64.7% of the respondents Muslims. Majority (72.6%), were married. 20.2% co-habiting and 7.2% single. Many (69.8%) had been previously pregnant. Most women (54.1%) started ANC in their second trimester, only 20.0% in their first trimester and 8.3% in the last trimester, while 17.6% had not started ANC at all. Knowledge score of respondents was 14.7±5.0, and 59.1% of the respondents had good knowledge of the various components of antenatal care services. Reasons for antenatal care registration included perceived health benefits (88.5%), reassurance of a normal pregnancy (86.6%), prevention of illness in pregnancy (74.7%) and vaccination (64.2%). Married respondents were almost twice likely to have registered for antenatal care compared to those that were single or co-habiting (OR: 1.8, C.I:1.0-3.4). Majority of the respondents (50,9%) had a monthly income of less than #10,000 and 11.9% had no income at all were less likely to have registered for antenatal care compared to those (37.2%) who had a monthly income of N10,000 and above (OR: 0.4, C.I:0.2-0,8), Respondents with poor knowledge of the components of antenatal care were less likely to seek for an care compared with those who had good knowledge (OR:0.5,C.I:0.3-0.8). The FGD revealed that many pregnant women were knowledgeable about the benefits of ANC but also complained of lack of funds and time as major reasons why pregnant women may not seek ANC services. Antenatal Care health seeking behaviour as assessed by utilization was relatively fair among pregnant women living in the urban slums of IBSELGA. Therefore, ANC health seeking behaviour among urban slum population can be improved by health education on the importance of the utilization of ANC services, social support initiatives and poverty alleviation programmes through community-based strategies.