HEALTH PROBLEMS AND PROVISIONS FOR PREGNANT WOMEN ATTENDING GOVERNMENT HOSPITALS IN MAIDUGURI METROPOLIS, BORNO STATE

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Abstract

The Study was conducted to ascertain the health problems and provisions for Pregnant Women attending Government Hospitals in Maiduguri Metropolis, Borno State. The cross-sectional survey research design was used for the study. Ten specific objectives were formulated with ten corresponding research questions and three null hypotheses were also postulated to guide the study.. The population for the study was three hundred and twenty eight pregnant women and eighty seven health personnel while the sample for the study consisted of 328 pregnant women and 87 health personnel. Two set of researcher designed questionnaire was the instrument used for data collection. The instrument was validated by five experts. The instrument has reliability index of .87. Percentages was used to answer research questions while chi-square statistics was used in testing the null hypotheses at .05 level of significance (p-value=.05). The results the study showed that physical health problem experienced among pregnant women were malaria (93.6%) anaemia (91.2%), headache (85.4%), backpain (81.1%), urinary tract infections (76.2%), pre-eclampsia (74..4%), haemorrhage (64.9%), constipation (64.9%), vaginal bleeding (60.4%) heartburn (56.1%), placenta previa (53.4%), diarrhea(52.4%), heamorrhoids (51.2%). While lower proportion of pregnant had dental problem (45.7%), and rhesus factor (35.1%).Majority of health personnel indicated that the antenatal services of booking at first time of attendance (100%), health education (100%), administration of routine drug and malaria (100%), administration of tetanus toxoid vaccine (100%) and treatment of ailment and history taking(100%) were adequately provided.  (37.9%) indicated that general assessment of mothers were provided, (25.3%) indicated that diagnose and treat complication are provided and medical examination (5.7%). Majority of the respondents indicated that the factors associated with health care provisions were lack of equipment (98.9%) inadequate funding (97.7%), inadequate number of staff (86.2%) and poor quality of staff (74.7%),cultural interference (20.7%) and lack of awareness of health facility/services (25.3%).There was no significant difference in such emotional health problem of pregnant women: alcoholism (χ²cal = 3.066, p-value = 216). while there was significant difference in the following emotional health problems moodiness and moodswing (χ²cal = 9.874, p-value = .007); ‘’anxiety’’(χ²cal = 44.769, p-value = .000), ‘’restlessness (χ²cal = 45.251, p-value = .000), ‘tension (χ²cal = 27.208, p-value = .00), ‘’aggression’’ (χ²cal = 16.169, p-value = .000), ‘depression’ (χ²cal = 16.345, p-value = .000) according to parity. The following Recommendation were made: Health workers, Government and non-governmental organization should organize health programme on safe motherhood, antenatal and postnatal programme for women especially those age 25-34 years. Federal Government should improve budgetary allocation to health as this will to a large extent, cater for new schemes such as proper welfare package for health personnel.

CHAPTER ONE

Introduction

Background to the Study

            The health of a pregnant woman determines to a large extent the health of the family. A healthy pregnant woman brings forth a healthy baby with better chance of survival. These have made us to know that health of pregnant women deserve special attention because during pregnancy, the extra demand made by the foetus on the mother and also due to hormonal influence, the mother is posed with many health problems, for one to understand health problems require that the concept of health be clarified (Park, 2009).

Health as a concept means different things to different people. The world health organization, (1948) defined health as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This embraces all aspect of human health namely physical, social, mental or emotional and it involves more than being ill in bed or being disabled. This is applicable to everyone including pregnant women at Maiduguri metropolis. By this wholistic definition of health, it means that one can indeed be free from disease or infirmity and yet experience health problem in any of the three dimension of health covered in the definition. Onuzulike (2008) viewed health as a multifaceted concept, consisting of six dimensions, namely: Physical health, mental health, social health, emotional health, spiritual health and occupational health. Park (2009) stated that health is a state of relative equilibrium of the body from function which results from its successful dynamic adjustment to forces tending to disturb it. It is that thing that makes you feel that now is the best and things that make you feel that now is the best time of the year, throwing up his hand in the morning and declare, “I feel great”. In this study, health is defined as a state of physical, emotional and social wellbeing of pregnant women which enables them to be fit during pregnancy. This is because WHO definition in 1948 used to be the mostly widely accepted and quoted definition in health. Therefore inability to adjust to changes within and outside the body, disequilibrium of the body to maintain normal function will then suggest the existence of health problem.

Health problem is seen as a state of disequilibrium, disease conditions and as a factor that predispose one to disease condition. According to Prothero (1994) health problem is a state of disequilibrium in which disease flourishes and health is impaired. He further stated that humankind and environment are closely linked in a complex relationship which frequently presents conditions of equilibrium between disease and health. Impairment of health according to him may manifest as a disease or infection. Meads (1994) posited that health problems represent something physical or emotionally and socially distressing for which relief is sought. In this definition health problems are categorized into three dimensions, such as physical, mental or emotional and social problems. Myles (2006) defined health problem as conditions which prevent individuals from mobilizing their physical, social and mental resources for optimal living. Thus any health condition which prevents pregnant women from attaining maximum working efficiency in daily tasks would constitute a health problem because it would not permit them to mobilize their physical, social and mental resources for optimal living. During the pregnancy period dozens of biochemical, physiological and anatomical changes occurs in woman’s body for such changes are beyond their control and are regarded as first changes that leaves women vulnerable physically and mentally (Weller, 2005). Worldwide health problem during pregnancy is an important issue. An estimated 500,000 women die each year throughout the world from complications of health problems regarding pregnancy and childbirth. Over 99 per cent of those deaths occur in developing countries such as Ghana. Maternal deaths only tell part of the story because for every woman or girl who dies as a result of pregnancy-related causes, between 20 and 30 more may develop short and long term health problems, such as malaria, anaemia, and pelvic inflammatory disease. The deaths and complications that arise from pregnancy are related to several crude practices of pregnancy handling and management including abortion by women (WHO, 2007). They added that Nigeria has the second highest maternal deaths in the world, one in every eight pregnant women die while giving birth; most of these deaths are avoidable as compared to the United State where 1 in 4,800 maternal mortality that are recorded. However, one of the millennium development goals is to improve maternal health care which was adopted by the international community at the United Nations Millennium Summit in the year 2000, by achieving 75 per cent drop from the level of maternal mortality in the year 2015. Coming to think of it, would this be really possible in Nigeria, where women die from wide range of complications in pregnancy, childbirth or postpartum, which in most cases are caused by poor health at the conception and lack of adequate care needed for healthy outcome of the pregnancy and their babies (Muhammed, 2011). Ozumba (2008) stated that in Nigeria 40 per cent of pregnant women experience pregnancy related health problems during or after pregnancy and childbirth. He further stated that maternal death has implication for the family, the community and the society in general. Its impact is most immediate and especially severe on young children. He added that one million children worldwide are left motherless every year, primarily because their mother had no access to or could not afford quality health care. Egwuatu (2003) stated that pregnant women face considerable barriers in assessing hospital services throughout the country. These barriers are largely due to poverty at household level. WHO (2007) observed that physical existence of health facility does not mean that they function. WHO further stated that most of them are poorly equipped and lack essential supplies of equipment and qualified staff. Madunagu and Olaniran (2005) stated that available data have shown that the availability and attending to quality health care service in Nigeria is poor. Agular and Galbes (2004) pregnancy now goes on with physical, social and emotional health problems which if not well managed, the consequences could lead to morbidity or mortality of mother and infant.  This cannot be less true about the pregnant women in Maiduguri metropolis in Borno state. Within the context of this study, health problems mean the physical, emotional or mental and social conditions which a pregnant woman encounters whether at the onset of pregnancy or as the pregnancy advances that give discomfort which lead to complication or even death. In this present study, physical, mental or emotional and social health problems were considered because WHO in 1948 used to be the most widely accepted and quoted definition of health.

HEALTH PROBLEMS AND PROVISIONS FOR PREGNANT WOMEN ATTENDING GOVERNMENT HOSPITALS IN MAIDUGURI METROPOLIS, BORNO STATE