OUTLINE
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Transcript of OUTLINE
THE RELATIONSHIP BETWEEN KNOWLEDGE OF GOAL ORIENTED ANTENATAL CARE AND ADHERENCE TO GOAL ORIENTED VISITS BY ANTENATAL CLIENTS
10th SOMSA CONGRESSST GEORGE HOTEL TSWANE
By Mrs. SOTAH MAHANYA 05 December 2012
OUTLINE
Background problem statement purpose and objectivesMethods sampling instruments data handlingResultsDiscussion
BACKGROUND
Complications during pregnancy and child birth are the leading causes of mortality and morbidity among women of reproductive age
WHO has recommended the new goal oriented ANC as a proven effective tool in preventing pregnant related complications.
- Four antenatal visits providing focused services
BACKGROUND
The old model consisted of 12-15 visits
The effectiveness of goal oriented ANC is based on adherence to recommended visits.
Zimbabwe is committed to fulfillment of the MDGs 4and 5, hence has adopted this protocol.
Other countries have also adopted it e.g. sub- Saharan countries
Problem Statement.
An increase in the number of pregnancy related complications was noted.
Of concern were stillbirths which had increased by 1.85% between 2006 and 2007
Reduction of mortality rate is expected instead of increase
- hence this has become a concern.
Problem Statement Cont.
Zimbabwe had a stillbirth rate of 17 per 1000 in 2000 and an infant mortality rate of 27 per 1000.
In 2007 the infant mortality rate increased to 60 per 1000 live births.
In 2011 the infant mortality rate of 29.5 per 1000 and stillbirth rate of 20 per 1000 live births
Southern Africa had an infant mortality rate of 23 per 1000 and still births rate of 21 per 1000
Globally 3.3 million babies are still born yearly.
Purpose
The purpose of this study was: - to examine the relationship between
knowledge of goal oriented antenatal care and adherence to goal oriented visits among antenatal clients at Morgenster Hospital.
Objectives
To assess adherence to goal oriented antenatal visits by antenatal clients
To identify the level of knowledge on goal oriented ANC among the antenatal clients
To examine the relationship between knowledge of goal oriented ANC and adherence to goal oriented antenatal visits
Methods
Study DesignA descriptive correlational design used.Sampling procedureSimple random sampling of 80 para 1,
gravida 2, and para 2,gravida 3 antenatal clients
Inclusion criterion was 36 weeks gestation and above.
The antenatal register was used to establish a sampling frame.
Research Instrument
Interview schedule comprising three sections used
• Section A – Demographic data questionnaire• Section B – Knowledge of goal oriented ANC • Section C – Adherence to goal oriented visits Questionnaire pre-tested at a rural health
center using a sample of 5.The instrument’s items were judged to have face
validity
Data Collection
Face to face interviews were conducted in English or vernacular.
The investigator recorded the responses for consistency.
At least twenty minutes were spent with each participant and private room was used.
Ethical Consideration
Permission to collect data was sought and granted by the Zimbabwe Medical Research Council
From hospital administrationWritten informed consent was sought
from the participants prior to the interviews.
The consent form addressed principles of beneficence, autonomy, and justice.
Data Analysis
Data analysis was done using the Statistical Package for Social Science (SPSS)
Descriptive statistics used to describe the data.
Inferential statistics namely Pearson’s Product Moment (r) as well as Regression analysis used to examine the relationship between the variables.
RESULTS
27.5% were aged 20-23 “youth” and those aged 32-35 constituted 13.8%
82.5% were married while 17.5% were either single, divorced or widowed
80% had attained secondary and higher education
56.3% booked before 16 weeks However, only 48.8% attended ANC
according to recommended dates, i.e. 51.2% non-adherence.
RESULTS
While 52.5% had correct information about the recommended number of goal oriented visits.
Knowledge on the services provided during goal oriented visits was limited
knowledge on signs and symptoms of pregnancy related complications also limited
- gross swelling of the face and feet (46, 25%) - severe pallor (36, 25%) - upper abdominal pain (32, 5%).
DISCUSSIONThe youth are prone to complications in
pregnancy hence – adherence important. World health report (2005)indicates that
educated women are in better position to understand information regarding their health.
The 51.2% non-adherence supports the findings by Mathole et al. (2004)
- women were not satisfied with the goal oriented visits and preferred the old model with more visits.
DISCUSSION
Danger symptoms should be informed to the clients from 26 weeks so that they report early.(Majoko et al 2006)
Non-adherence could have resulted in the limited knowledge
RelationshipThe correlation coefficient (r) between
knowledge of goal oriented ANC and adherence to goal oriented visits was -0.518.
DISCUSSION
This relationship was significant with R2=0.269.
This suggests that adherence to goal oriented antenatal visits is affected by knowledge of goal oriented ANC.
52.5% knowledge is, however marginal considering the participants, level of education
This also suggests that there could be other factors affecting adherence to goal oriented antenatal visits
- considering results from other studies that some prefer the old protocol
RECOMMENDATIONS
Goal oriented antenatal care protocol should be strengthened and adherence emphasized .
Health education to include explaining the goal oriented ANC protocol
Pamphlets on signs of pregnant related complications , and signs of labor in both vernacular and English .
A study focusing more on barriers to adherence to goal oriented antenatal visits.
Limitations: study carried out at 1 institution
CONLUSIONGoal oriented antenatal care protocols if adhered to,
results in good quality ANC and reduction of complications.
any slight increase especially in stillbirths or maternal mortality would cause concern.
The findings showed that attendance of ANC according to recommended times is affected by the knowledge acquired from health education by midwives .
Health education should therefore aim at ensuring that the clients appreciate its effectiveness of goal oriented ANC through adherence.
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