INFORMATION SEEKING BEHAVIOUR OF PREGNANT WOMEN IN SELECTED HOSPITALS OF IBADAN METROPOLIS

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INFORMATION SEEKING BEHAVIOUR OF PREGNANT WOMEN IN
SELECTED HOSPITALS OF IBADAN METROPOLIS

Abstract
This study sought to ascertain the information seeking behaviour of pregnant women in
selected hospitals of Ibadan Metropolis. The study adopted the survey design. The study’s
population encompassed of 1900 pregnant women in selected hospitals. Proportional
random sampling technique was used to draw samples from each hospital. A
questionnaire was used for data collection. Data was analyzed using the frequency
distribution and percentage counts. Findings revealed that information on environmental
cleanliness and immunization were mostly needed by the respondents. Doctors and
nurses were also identified as the most available and utilized sources of health
information. Libraries were, however, found to be the least available and utilized source of
health information. Challenges facing information seeking were attributed mainly to
libraries, lack of income and time. The study concludes by noting that the availability,
access to, and utilization of health information would translate to a safe delivery thereby
reducing maternal mortality and recommends that government provides libraries and
free medical care to encourage women to seek health information, among others.
Keywords: Health information; Information seeking behaviour; Maternal
mortality; Pregnancy; Pregnant women.
Introduction
Pregnancy is not only a period of physical changes but also a period in a
woman‘s life when health related behaviours are most vital as decisions taken in
pregnancy could affect the life of a mother and her unborn fetus. For pregnant
women to adequately live a healthy life and ensure the safe delivery of their
babies, they need to search and acquire information necessary for healthy living.
The search for information, however, starts with the identification of a gap in
Uloma Doris Onuoha and Adedotun Adekunle Amuda are both of the Department of Information
Resources Management, Babcock University, Ogun State and can be contacted through
ud_onu@yahoo.com and amuda_adedotun@yahoo.com
Uloma Doris Onuoha & Adedotun Adekunle Amuda
knowledge, for which the individual makes an effort to bridge. As noted by
Allen (1996) information need occurs whenever an individual‘s knowledge fails.
Dervin (1992) also points out that information need results from the effort of
making sense which thus results in bridging of gap in an individual‘s
knowledge.
The twenty-first century has witnessed a remarkable evolution as evident in
considerable large increase of technology ranging from bibliographic to full text
database. Wilson (2000) notes that in the course of seeking information, an
individual may interact with manual information in the form of newspaper or a
library or with computer–based systems such as the web. Information can,
therefore, be derived from a variety of sources, including books, journals, the
Internet, friends/relatives, persons at the workplace or professional advisors.
Despite the abundance of information sources, the well being of pregnant
women remains a major concern in the world. It is, therefore, not surprising that
147 heads of states met in September 2001 and collectively endorsed Millennium
Development Goals (MDGs), part of which is to reduce child mortality rate by
2/3 and maternal mortality ratio by 3/4 between 1990 and 2015 (UNICEF, n.d.).
The concern for maternal well being is justified as UNICEF (2009) observed that
in the poorest parts of the world, the risk of a woman dying as a result of
pregnancy or childbirth during her lifetime is about one in six compared to about
one in 30,000 in Northern Europe. India, being a developing country, contributes
26% of the global burden of maternal deaths with nearly 136,000 women dying
annually due to causes related to pregnancy and childbirth. According to Udofia
& Okonofua (2008) available evidence indicates that Africa accounts for the
highest burden of mortality among women and children in the world. UN World
Population Prospects & the Institute for Health Metric Reports (2010) as cited in
Oyedele (2012)) affirms that Nigeria ranks high among the list of countries with
high maternal and infant mortality rates with a ratio of 545 per 100,000 live births
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
on the maternal mortality index and 75 per 1000 live births on the infant
mortality index. Such revelation, therefore, makes it necessary to study the
information seeking behaviour of pregnant women as this would no doubt create
more awareness of the seriousness of maternal health care issues. Also, it is
important to identify the real ways of meeting the information needs of pregnant
women which was the main focus of this study.
Information has been recognized over the world as an important tool for making
decisions and reducing uncertainty. However, despite the abundance of
information resources in a variety of sources, literature still reveals that mortality
rate among pregnant women is still high especially in Nigeria and other
developing countries. Where such situation continues to exist, more women
would likely die from preventable pregnancy related causes. It is the light of this
that the study investigated the information seeking behaviour of pregnant
women in selected hospitals of Ibadan Metropolis. Ibadan is the capital city of
Oyo State, located in the forest zone of southwestern Nigeria. Ibadan city lies on
the longitude 3°5′ East of Greenwich meridian and latitude 7°23′ North of the
Equator. Besides being the largest indigenous city in Africa, south of Sahara, the
city is an important trade and educational centre. It also houses one of the largest
and foremost teaching hospitals in Africa. However, the city is characterized by
low level of environmental sanitation, poor housing, and lack of potable water
and improper management of wastes especially in the indigenous core areas
characterized by high density and low income populations (Okonko & Udeze,
2011).
Objectives of the study
The general objective of this study is to ascertain the information seeking
behaviour of pregnant women. The specific objectives are to identify the:
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Uloma Doris Onuoha & Adedotun Adekunle Amuda
i. information needs of pregnant women;
ii. sources of health information available to pregnant women;
iii. extent of use associated with health information sources;
iv. challenges facing pregnant women when seeking information.
Literature review
Pregnancy, particularly first pregnancy, is a major transition in every woman‘s
life (Hofberg & Ward, 2003; Schneider, 2002). This is particularly so as a pregnant
woman finds herself in a unique and relatively new context, in which she
undergoes major physical, psychological, and social transformations. Aarts &
Dijksterhuis (2000) state that although pregnancy is exciting, a woman may also
experience doubts and uncertainties about her new identity as a potential mother
and her life style, which may in turn trigger her to rethink and reconsider a lot of
her behavior, including her nutrition. And since high quality nutrition is of extra
importance during this period, it becomes one of the few logical moments in a
woman‘s life when it is necessary to rethink nutrition habits (Anderson, 1996).
The findings of a study by Szwajcer; Hiddink; Mese; Koelen & VanWoerkum
(2008) further affirm that women are more interested in nutrition information
during pregnancy than before conception.
Giugliani; Caiaffe; Vogelhut; Witter & Perman (1998) on the other hand,
identified information relating to baby feeding as an information need of
pregnant women. This is particularly so as women often express concern over
breast feeding and formula feeding. In a related study Saleh & Lasisi (2011)
identified ante-natal and post-natal care, immunizations especially on the six
childhood killer diseases, prevention and management of Vascular Virginal
Fistula (VVF), and delivery options as the paramount health information
required by rural women.
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
Bernhardt & Felter (2004), affirm that there are countless books, magazines,
videos, television programs, classes, and other resources on childbirth, parenting,
and pediatrics from which mothers and mothers-to-be can choose. This was
corroborated by Hsieri & Brennan (2005) who conducted open-ended question
that asked participants about the information resources they used prior to their
clinic visit. The responses from this exercise included books, pamphlets and the
Internet.
In a research conducted by Aaronson, Mural & Pfoutz (1988), it was revealed that
major sources of information were health care providers and books. Providers
topped the list with 1845 points, followed by books (1608 points), friends (925
points), print media (910 points), family (753 points), self (598 points), and
audiovisual media (380 points). They finally concluded that multiple channels of
acquiring information were used by pregnant women. Shieh, McDaniel and Ke
(2009) in a study of low income pregnant women affirmed that health care
providers were the highest source of information. In a similar study on women‘s
health information needs and information sources, Nwagu and Ajama (2011)
identified family and friends, local herb hawkers, local drug sellers (hawkers)
and traditional healers as the most utilized information sources.
Burnett, Jaeger, and Thompson (2008) opine that access has three components:
physical, intellectual, and social. Physical access according to them includes the
physical structures that contain information, the electronic structures that contain
information, and the paths that are traveled to get to information and suggest
that geography and technology can affect physical access. Intellectual access, on
the other hand refers to understanding information in a document and traits
such as physical or cognitive (dis)abilities, language competence, and
technological literacy can limit access to information. Social access suggests that
elements of one‘s social world, including social norms and worldviews, influence
which information one accesses, and how and why particular information is
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Uloma Doris Onuoha & Adedotun Adekunle Amuda
sought. This view is corroborated by McKenzie (2002) who affirms that
information seekers are faced with three kinds of barriers which may originate
with either the information provider or the seeker, or both the provider and the
seeker. In a study, Glenton (2002) found out that barriers to accessing
information includes the use of medical terminology by the information source
or provider which may not be understood by the information seeker and lack of
communication skills by the information seeker. van Ryn (2002) affirm that
health information professionals can exhibit biases based on race, culture, and
socio-economic status when sharing information. Parker; Ratzan & Lurie (2003)
also affirm that lower levels of literacy and the understanding of medical
information constitute barrier to health information seeking. Gazali; Muktar &
Gana (2012), on the other hand, identified low self-esteem and sociodemographic
factors among the problems facing women when seeking for
information.
Methods
This study adopted the survey design method. The study’s population
encompassed of 1900 pregnant women in selected hospitals of Ibadan
Metropolis, Oyo State, Nigeria. Proportional random sampling technique was
used to draw samples from each hospital. This study was restricted to pregnant
women registered for antenatal care during the period of the study in selected
hospitals of Ibadan Metropolis. The selected hospitals were limited to a primary
health care center, a private hospital, a state hospital and a federal hospital.
These hospitals were selected because they represent the four sectors of hospitals
and health care clinics in the city A questionnaire was used for data collection.
Data was analyzed using the frequency distribution and percentage counts.
Findings and discussion
Table 1: shows the various hospitals and the corresponding number of
respondents selected from each hospital.
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
Table 1: Selected hospitals and the corresponding numbers of respondents
HOSPITALS POPULATION 25% FOR SAMPLE
Oluyole Health Center 190 47
Ibadan Central Hospital 158 40
Adeoyo Hospital 552 138
University College Hospital 1000 250
TOTAL 1900 475
Information Needs of Pregnant Women
Respondents were asked to indicate their information needs and the results are
displayed in Table 2.
Table 2: Information needs of pregnant women
S/N INFORMATION NEEDS OF Very Often Sometimes Rarely Never PREGNANT WOMEN Often
F (%) F (%) F (%) F (%) F (%)
1. Environment Cleanliness 287(69.7) 63(15.3) 15(3.6) 9(2.2) 38(9.2)
2. Immunization 271(65.8) 56(13.6) 24(5.8) 13(3.2) 48(11.7)
3. Disease Prevention and Control 257(62.4) 73(17.7) 14(3.4) 14(3.4) 54(13.1)
4. Personal-care 248(60.2) 68(16.5) 20(4.9) 19(4.6) 57(13.8)
5. Baby-care 263(63.8) 59(14.3) 19(4.6) 18(4.4) 53(12.9)
7. Nutritional/Dietary 199(48.3) 72(17.5) 41(10.0) 50(12.1) 50(12.1)
6. Emotional Support 179(43.4) 89(21.6) 74(18.0) 21(5.1) 49(12.0)
8. Family Planning 115(27.9) 59(14.3) 44(10.7) 34(8.3) 160(38.8)
Table 2 reveals that considerably high number of the respondents 287 (69.7%)
require information on environmental cleanliness. This was followed by
information on immunization 271 (65.8%), disease prevention and control 257
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Uloma Doris Onuoha & Adedotun Adekunle Amuda
(62.4%), personal-care 248 (60.2%), baby-care 263 (63.8%), information on family
planning was found to be the least needed.
Availability of health information sources
The sources of health information available to the respondents are shown in table
3.
Table 3: Availability of health information sources
Sources of Health Information Available to Yes No Pregnant Women
Doctors 385 (93.4%) 27(6.6%)
Nurses 359 (87.1%) 33 (8.0%)
Pre-Natal health education classes 337 (81.8%) 75 (18.2)
Television 321 (77.9%) 91 (22.1%)
Friends 297 (72.1%) 115 (27.9%)
Radio 293 (71.1%) 119 (28.8)
Family Members 293 (71.1%) 119 (28.9%)
Books 283 (68.7%) 129 (31.3%)
Other Pregnant Women 268 (65.0%) 144 (34.9%)
Newspaper or Magazines 248 (60.2%) 164 (39.8%)
Pamphlets 247 (60.0%) 165 (40.0%)
Film/Slide Projection 239 (58.0%) 173 (42.0%)
Internet 234 (56.8%) 178 (43.2%)
Bulletins/Newsletter 206 (50.0%) 205 (50.0%)
Library 125 (30.3%) 287 (69.7%)
Majority of the respondents 385 (93.4%) stated that doctors are the most available
source of information, followed closely by the nurses with 359 (87.1%). Libraries
were, however, found to be the least source of health information available to
respondents with 125 (30.3%).
Types of Health Information sources Utilized by Pregnant women
In order to determine the level of use associated with health information sources,
respondents were asked to indicate the extent of utilization. Findings are shown
in Table 4.
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
Table 4: Utilization of information sources
TYPES OF INFORMATION SOURCES Very Heavily Highly Moderately Rarely Never
Utilized Utilized Utilized Utilized Utilized UTILIZED F (%) F (%) F (%) F (%) F (%)
Doctors 299(72.6%) 52(12.6%) 28(6.8%) 9(2.2%) 24(5.8%)
Nurses 234(56.8%) 78(18.9%) 38(9.2%) 11(2.7%) 51(12.4%)
Pre-Natal health education classes 224(54.4%) 65(15.8% 25(6.1%) 19(4.6%) 79(19.1%)
Family Members 205(49.8%) 75(18.2%) 66(16.0%) 36(8.7%) 30(7.3%)
Television 184(44.7%) 49(11.9%) 58(14.1%) 38(9.2%) 83(20.1%)
Other Pregnant Women 176(42.7%) 70(17.0%) 75(18.2%) 43(10.4%) 48(11.7%)
Radio 166(40.3%) 62(15.0%) 60(14.6%) 41(10.0%) 83(20.1%)
Friends 165(40.0%) 70(17.0%) 78(18.9%) 41(10.0%) 58(14.1%)
Newspaper or Magazines 165(40.0%) 63(15.3%) 61(14.8%) 42(10.2%) 81(19.7%)
Pamphlets 158(38.3%) 36(8.7%) 63(15.3%) 60(14.6%) 95(23.0%)
Internet 155(37.6%) 49(11.9%) 36(8.7%) 37(9.0%) 135(32.8%)
Books 134(32.5%) 66(16.0%) 55(13.3%) 38(9.2%) 119(28.8%)
Bulletins/Newsletter 97(23.5%) 43(10.4%) 62(15.0%) 55(13.3%) 155(37.6%)
Library 88(21.4%) 45(10.9%) 41(10.0% 43(10.4%) 195(47.3%)
Film/Slide Projection 82(19.9%) 45(10.9%) 62(15.0%) 49(11.9%) 174(42.2%)
Findings from table 4 reveals that respondents highly utilize the following source
of health information: Doctors 299 (72.6%), Nurses 234 (56.8%), pre-natal health
education classes 224 (54.4%). On the other hand, Film/Slide Projection 82
(19.9%) and library 88 (21.4%) were the least utilized sources of information.
Challenges faced by pregnant women when seeking information
Respondents were asked to identify challenges facing them when seeking health
information and the result is displayed in table 5
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Uloma Doris Onuoha & Adedotun Adekunle Amuda
Table 5: Challenges in seeking health information
Challenges of seeking health Very Challenging Challenging Not Challenging information
F (% ) F (% ) F (% )
Lack of Library or Information Centre 163(39.6%) 101(24.5%) 148(35.9%)
Lack of Income 107(26.0%) 98(23.8%) 168(40.8%)
Lack of Time 100(24.3%) 109(26.5%) 203(49.3%)
High Cost of Information 99(24.0%) 69(16.7%) 244(59.3%)
Lack of Qualified Health Professional 94(22.8%) 73(17.7%) 245(59.5%)
Lack of Awareness on the existence of
information 93(22.6%) 113(27.4%) 206(50.0%)
Lack of Mobile Phones 85(20.6%) 64(15.5%) 263(63.8%)
Lack of television 82(19.9%) 47(11.4%) 283(68.7%)
Level of Education 78(18.9%) 57(13.8%) 277(67.2%)
Material Age 74(18.0%) 73(17.7%) 265(64.3%)
Geographical Location 72(17.5%) 102(24.8%) 238(57.8%)
Distance to the Source of Information 69(16.7%) 100(24.3%) 243(59.0%)
Lack of Radio 69(16.7%) 80(19.4%) 263(63.8%)
From table 5, challenges faced in seeking health related information had a good
spread with the highest challenge being lack of Library or Information centers
163 (39.6%), followed closely by lack of income 107 (26.0%) and time 100 (24.3%).
Discussion
Information needs of pregnant women are linked closely to disease control as
findings indicate that their information needs are more on: environmental
cleanliness, immunization, disease control and personal-care or personal
hygiene. The finding is consistent with those of Aarts & Dijksterhuis (2000), Saleh
& Lasisi (2011), who identified environmental cleanliness, change of life-style
(personal-care), ante-natal and post-natal care that involves immunization,
childhood care orientation, prevention and control of diseases as information
needs of pregnant women. The finding is not surprising, considering the sanitary
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
condition of most cities in developing countries where dirt litters the
environment and a large number of children are still affected by infant diseases.
Information sources available to respondents were found to be mostly medical
personnel such as doctors and nurses. The finding is consistent with findings of
Aaronson, Mural & Pfoutz (1988), Shieh, McDaniel & Ke (2009), whose studies
revealed that health care providers and are major sources of information for
pregnant women. Apart from the personal attention rendered to pregnant
women by doctors and nurses, some hospitals also run pre-natal health
education classes to further educate women. What is surprising in the study,
however, is the fact that some respondents, though few in number, actually
affirmed that they do not have access to doctors and nurses. Considering the fact
that the study respondents are duly registered for anti-natal care in hospitals, it is
expected that medical personnel would be available to them. The implication is
that though registered for anti-natal care, some women may still not have access
to medical personal.
Majority of the respondents also affirmed that health practitioners were the most
utilized source of information. This is actually expected taking into consideration
that they are the most available source of information. The findings, however,
disagrees with the finding of Nwagu & Ajama (2011) who identified family and
friends, local herb hawkers, local drug sellers (hawkers) and traditional healers
as the most utilized information sources. The disparity in the findings may not be
unrelated to the fact, that Nwagu & Ajama‘s study was restricted to women in a
rural area. It was, however, worrisome to note that the library is among the least
utilized sources of information despite the fact that some of the respondents
affirmed using print materials such as books and pamphlets. The implication
here is that the study respondents‘ are willing to read books but in situations
where libraries are not available to them, there is no way they can utilize them.
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Uloma Doris Onuoha & Adedotun Adekunle Amuda
A host of challenges were found to face pregnant women in the search for
information. Among the challenges faced by the respondents are: lack of
library/information center, lack of income and lack of time. This, no doubt,
explains the low rating given to the library in terms of availability and use.
Where libraries do not exist, there is no way they can be utilized. Lack of income
as a major challenge also offers possible explanation for why some respondents
though registered in hospitals claim not to have access to doctors and nurses.
This is in agreement with the assertion of van Ryn (2002) who affirms that health
information professionals can exhibit biases based on race, culture, and socioeconomic
status when sharing information. It is, therefore, possible that doctors
and nurses pay little attention to those with little income.
Conclusion
This paper has captured so many issues as it relates to information seeking
behaviour of pregnant women in Ibadan Metropolis. Information is considered
as a major ingredient in enhancing the well being of an individual and as such
needed in time of pregnancy. The availability, access to and utilization of health
information would, no doubt, translate to a safe delivery and healthy life style
for a woman during pregnancy thereby reducing maternal mortality. The essence
of any research activity is to enhance practice and overall progress by generating
new information that will either improve the already existing practices or
introduce entirely new ways of doing things. Based on the findings, it is
recommended that the government and other concerned health agencies or
bodies:
a. provide necessary infrastructure (like the library) that will serve as
a source of health information
b. provide free medical care to reduce the financial constraints
associated with hospital visits as this would encourage more
women to seek health information from health care providers
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Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan
Metropolis
c. establish more primary health care centers since this will reduce the
distance and time spent in seeking health related information.
d. find avenues of promoting health information using posters
displayed in hospitals, or even going beyond the hospital premises
to places such as markets and schools, and having health
practioners address issues of health in pregnancy.
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