ABSTRACT Background: In Low and Medium income countries (LMICs) focus antenatal care (FANC) services are so low, below the recommended threshold. In Uganda, high maternal and neonatal mortalities have been attributed to the severe variations in F ANC coverage in rural communities. Aim: This study was to determine factors affecting utilization of FANC services in Kitagata Hospital of sheema district, Uganda. Materials and Methods: This was a cross-sectional study carried out for a period of 5 months involving 100 participants who were chosen randomly. A semi-structured questionnaire was used to collect data on population demographics, knowledge on benefits and challenges as well as alternative options associated with F ANCs at the health center. Data was recorded in MS Excel Version 2013 and analyzed using SPSS Version 20 and chi-square tests were conducted at 95% significance. Results and Discussion: Majority of participants in the study were adults in the age of 20-29yrs, with the highest level of education being secondary. This showed that the community had the ability to read and would definitely appreciate health care messages passed on to them. This would have affected the high tmnover for screening, testing and immunization activities in this period, thus showing a great level of knowledge in this regard. Utilization of fansidar to control malaria was a common practice; however the uptake of Iron/Folic acid in this community was low, thus showing a need to emphasis its usage in this community. The major alternative to FANCs was identified to be herbal therapies for malaria i.e. bothrioclinelongipes which is often taken orally. Conclusion and Recommendation: The long distances covered to attend F ANCs and high transportation costs are major factors influencing their full utilization in rmal communities. In addition, the need to improve on Iron/Folic acid supplementation needs to be emphasized in rmal health facilities and studies to assess the toxicological effects associated with herbal therapies that are used in discriminatively need to be carried out in prospective studies.
TABLE OF CONTENTS
DECLARATION ............................................................................................................................. .i
APPROVAL ................................................................................................................................... ii
DEDICATION ............................................................................................................................... iii
ACKNOWLEDGEMENT .............................................................................................................. iv
TABLE OF CONTENTS ................................................................................................................ v
OPERATIONAL DEFINITIONS OF TERMS ........................................................................... viii
CHAPTER ONE : INTRODUCTION ......................................................................................... !
1.1 Background ................................................................................................................................ !
1.2. Statement of the Problem ......................................................................................................... 4
1.3 Broad objective .......................................................................................................................... 4
1.4 Specific objectives ..................................................................................................................... 4
1.5 Research questions .................................................................................................................... 5
1.6 Study justification: ..................................................................................................................... 5
1.7 Scope of study ........................................................................................................................... 5
1.8 Conceptual frame work: ............................................................................................................ 6
CHAPTER TWO: LITERATURE REVIEW ............................................................................ 9
2.1 General overview on FANC ...................................................................................................... 9
2.2 Early detection and treatment ofcomplication: ......................................................................... 9
2.3 Prevention of complications: ..................................................................................................... 9
2.4 Birth preparedness and complication readiness: ....................................................................... 9
2.5 Health promotion and counseling: ........................................................................................... 1 0
2.6 Focused antenatal care (FANC) model outlined in WHO clinical Guidelines: ...................... 11
2.7. Socio-economic and demographic characteristics of pregnant mothers ................................ 12
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CHAPTER FIVE : DISCUSSION ............................................................................................. 27
Objective I ..................................................................................................................................... 27
Objective II .................................................................................................................................... 28
Objective III ................................................................................................................................... 29
CHAPTER SIX: CONCLUSION AND RECOMMENDATION ........................................... 31
Reference: ...................................................................................................................................... 32
APPENDIX I: MAP OF UGANDA .............................................................................................. 38
APPENDIX ll: MAP OF SHEEMA DISTRICT SHOWING KITAGATA HOSPITAL ............ 39