ASSESSMENT OF THE KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN TOWARDS ANTENATAL CARE SERVICE IN EKPAN COMMUNITY

TOPIC IS SUITABLE FOR:
1. Department of Nursing Science

2. Department of Public Health

3. Department of Midwifery

4. Department of Community Health

TOPIC: ASSESSMENT OF THE KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN TOWARDS ANTENATAL CARE SERVICE IN EKPAN COMMUNITY

TABLE OF CONTENT

Abstract

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study

1.2 Statement of the Problem

1.3 Objective of the Study

1.4 Research Questions

1.5 Significance of the Study

1.6 Scope of the Study

1.7 Operational Definition of Terms

CHAPTER TWO: REVIEW OF LITERATURE

2.1 Conceptual Framework

2.2 Theoretical Framework

2.3 Empirical Review

2.4 Summary of Literature Reviewed

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design.

3.2 Research Settings

3.3 Population of the Study

3.4 Sample Size

3.5 Sampling Techniques

3.6 Instrument for Data Collection

3.7 Validity of the Instrument

3.8 Reliability of the Instrument

3.9 Procedure for Data Collection

3.10 Methods of Data Analysis

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS OF DATA

4.1 Data Presentation.

4.2 Analysis of Data.

CHAPTER FIVE: SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS

5.1 Discussion of Findings

5.2 Implications of findings to nursing    

5.3 Limitation of the Study

5.3 Summary of the study

5.4 Conclusion    

5.5 Recommendation  

5.6 Suggestion for further Findings

Reference

Appendices

ABSTRACT
This study “assessed the Knowledge and Attitude of Pregnant Women Towards Antenatal Care Services in Ekpan Community”. The specific objectives were to assess the level of knowledge toward antenatal care services; determine the extent of utilization of ANC services; examine attitudes toward ANC services; and identify factors influencing knowledge and attitudes among pregnant women in Ekpan Community, Delta State. The study adopted a descriptive survey design. The population comprised 430 pregnant women attending antenatal clinics in the community. Using Taro Yamane’s formula, a sample size of 193 respondents was validated. A multi-stage sampling technique involving stratified and convenience sampling was used to select participants. Data were collected using a structured questionnaire and analyzed using descriptive statistics such as frequency, mean, and standard deviation. A decision benchmark mean of 2.50 was used. The findings showed that respondents demonstrated a high level of knowledge on ANC services (mean = 3.32), moderate utilization (mean = 2.94), and a generally positive attitude (mean = 3.28). Key influencing factors such as educational level, proximity to facilities, and spousal support were identified with item means ranging from 2.86 to 3.45. Based on these results, it was recommended that community-based health education should be intensified, male involvement in ANC be encouraged, and ANC services be made more accessible through outreach efforts. Religious and traditional leaders should also be mobilized to dispel myths and promote early ANC booking. These measures are expected to bridge the knowledge-practice gap and improve maternal health outcomes in Ekpan and similar communities.

Keywords: Antenatal care, pregnant women, knowledge, attitude, utilization, Ekpan Community, maternal health.

CHAPTER ONE

INTRODUCTION (Preview)

1.1 Background of the Study

Health has been since long ago known as a fundamental human right and a principal engine of socioeconomic development. Health, based on the World Health Organization, is not merely the absence of disease but a state of full physical, mental, and social well-being (Janakiraman et al., 2021). True to international ambitions such as the Sustainable Development Goals (SDGs), maternal and child health remains a priority of health systems worldwide. This is in view of the fact that maternal health has immediate implications on community health outcomes and intergenerational well-being (Drigo et al., 2024). It has, however, for a long time been a principal barrier to optimal maternal health in the developing world that disparities in the use of quality health care services have existed. Attempts at the institutional and grassroots levels to eliminate such disparities through specialized health services such as antenatal care (ANC) are, however, concerted. ANC is widely recognized for its potential in preventing maternal and neonatal morbidity and mortality (Abazie et al., 2021).

Antenatal care services constitute a composite package for guaranteeing the health of pregnant women through medical assessment on a regular basis, nutrition, education, and disease prevention interventions. Antenatal care, as argued by Adebayo and Martins (2024), is a clinical responsibility and a means of public health intervention, reinforcing pregnant women's knowledge on preparedness for childbirth and early detection of pregnancy complications. Its role is also to facilitate healthy behavior and allow psychological care for pregnant women, thereby ensuring good maternal outcomes. ANC, in the opinion of Okafor et al. (2024), is typically the first formal contact that women in the majority of low- and middle-income countries experience with the health system and thus acts as an entry point to complete maternal care. The simplicity of ANC's nature being understood by researchers and policymakers makes it easy to evaluate its feasibility, implementation, and utilization across different communities.

Knowledge underpinning antenatal care is critical to its uptake, as explained by Adigun and Mngomezulu (2024). Knowledge of ANC content, timing, and salience among women is the greatest determinant of the intention to use the service. This knowledge is typically based on formal schooling, cultural beliefs, health literacy, and the quality of communications from health providers. Nwabueze et al. (2023) affirm that increased awareness translates to earlier registration and higher frequency of ANC visits, both of which are critical to a healthy maternal and neonatal outcome. Knowledge scope, however, does not simply depend on availability but also on the accessible quality of health information. Health education during pregnancy in the majority of peri-urban and rural settings remains intermittent and sometimes fragmented, thereby influencing maternal behavior in diverse ways.

Attitude, however, refers to the psychological position that individuals develop towards a specific concept or practice, in our instance, ANC. As postulated by Adesida et al. (2023), positive attitude towards antenatal care is a significant determinant that significantly encourages uptake and compliance with the services. Experience, cultural values, perceived utility of care, and interpersonal behavior of caregivers are responsible for attitude formation. Olukemitan et al. (2024) also clarify that perceived quality of service, such as caregiver attitude, has a direct correlation with the intention of women to return for follow-ups. Where traditional values dominate reproductive health practice, attitudes towards modern maternal health care services may be ambivalent or even resistant, thereby affecting maternal choices and outcomes in complex ways.

Moreover, a knowledge and attitude measure provides a twofold perspective in which the communities' interaction with existing maternal health services may be studied. Drigo et al. (2024) believe that behavioral and cognitive model-based measurements have the potential to unveil facilitators and barriers to ANC service utilization. Measures like these are needed so that location-specific interventions may be established in order to address information gaps and behavior barriers. For health managers and researchers, a full picture of service uptake patterns and the related sociocultural context can be accessed through a knowledge and attitude comprehension. That in mind opens possibilities for community-tailored solutions to be established that are both tailored to the pregnancy woman's expectation or lived experience and to the specific location.

Against this broader backdrop, Ekpan community in Delta State, Nigeria, presents an interesting case for the study of antenatal care dynamics. Both a mixed socio-economic and urbanising settlement, Ekpan represents both the promise and challenge of maternal health access in Nigeria. Abazie et al. (2021) observe that variation in health infrastructure availability, levels of education, and social norms in such settlements tends to impact the rate of uptake of antenatal care. It is this rationale, therefore, that an inquiry into pregnant women's knowledge and attitude toward ANC services in Ekpan contributes to the literature in addition to informing localised health planning and policy implementation. In a comparable context with work by Okafor et al. (2024) and Nwabueze et al. (2023), awareness of this group's behavioral categories towards maternal care informs improved health outcomes in addition to national reproductive health objectives.

1.2 Statement of the Problem

Antenatal care (ANC) is one of the most significant components of maternal health care systems across the globe. ANC is the primary platform for essential services that can prevent pregnancy and childbirth complications, ensuring maternal and newborn health (Drigo et al., 2024; Janakiraman et al., 2021). The World Health Organization recommends at least eight ANC contacts for every pregnant woman for optimum outcomes. Nevertheless, across most settings despite guidelines and evidence of ANC benefits, pregnant women's access to, knowledge of, and awareness of these services continue to vary (Adebayo & Martins, 2024). Such heterogeneity is typically a reflection of the varying sociocultural, economic, and educational profiles, alongside community-specific perceptions of health and infrastructure. In the bigger picture, in a community-based setting, it is crucial to investigate knowledge and attitude in order to be familiar with local antenatal service utilization.

In the majority of developing environments, like Nigeria, there is a large gap between access to antenatal care services and their usage by pregnant women. Specifically, in environments like Ekpan in Delta State, studies indicate that level of knowledge and attitude towards ANC services are not in line with the country's general goals of enhancing maternal health (Okafor et al., 2024; Adesida et al., 2023). Ideally, all pregnant women should make early and frequent visits to ANC during pregnancy with sufficient information and proper attitude. Reports, however, reveal that participation in ANC in most areas remains sporadic, and in most instances, begins late in pregnancy duration, undermining its potential benefits (Nwabueze et al., 2023). Such departures from the ideal suggest informational voids and attitudinal issues curtailing maximum utilization of ANC services.

Furthermore, current research has not examined extensively how localized attitudes and knowledge of ANC services affect maternal behavior in specific communities such as Ekpan. While certain studies give discussion of general national trends in ANC, there are few targeted evaluations where knowledge and attitude are simultaneously measured as variables that inform community-level utilization patterns (Adigun & Mngomezulu, 2024; Abazie et al., 2021). This is a critical shortcoming in effective maternal health intervention design, particularly for interventions targeting urbanizing, socioeconomically diverse populations such as Ekpan. The present situation reflects a piecemeal understanding of the behavioral and cognitive determinants of maternal healthcare use, when a best-practice framework would transfer community-specific evidence to inform guiding health education and outreach programs.Hence, the purpose of this study is to assess the knowledge and attitude of pregnant women in Ekpan community about antenatal care services.

1.3 Objective of the Study

The main objective of this study is to examine the knowledge and attitude of pregnant women towards antenatal care service in Ekpan Community. Other objectives of this study are:

1.To assess the level of knowledge toward antenatal care services among pregnant women at in Ekpan community.

2.To assess the extent to which antenatal care services are utilized among pregnant women at in Ekpan community.

3.To examine the attitudes toward the utilization of antenatal care services among pregnant women in Ekpan community.

4.To identify the  factors influencing knowledge and attitude toward antenatal care among pregnant women in Ekpan community.

Other parts of chapter one include:
1.4 Research Questions

1.5 Significance of the Study

1.6 Scope of the Study

1.7 Operational Definition of Terms

CHAPTER TWO

LITERATURE REVIEW (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter therefore, focuses on the overview of antenatal care, importance of antenatal care (ANC) adherence among mothers, knowledge and awareness of pregnant women towards antenatal care services, utilization of antenatal care service among pregnant women etc. The chapter covers the following subheadings:

2.1 Conceptual Framework

2.2 Theoretical Framework

2.3 Empirical Review

2.4 Summary of Literature Reviewed

CHAPTER THREE

RESEARCH METHODOLOGY (Preview)
Research Design: The study adopted a descriptive cross-sectional survey design.

Population of the Study: The population of the study comprises 430 pregnant women registered for antenatal care services at health facilities in Ekpan Community, Uvwie Local Government Area, Delta State, as of 2024.

Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 207 participants.

Sampling Technique: The study employed a multi-stage sampling technique involving stratified and simple random sampling methods to select the individual respondents.

Research Instrument: The study utilized a self-developed structured questionnaire as the instrument for data collection.

Methods of Data Analysis: The collected data were analyzed using frequencies, percentages, means, and standard deviations to summarize and present the demographic characteristics of the respondents and their responses.

CHAPTER FOUR; DATA PRESENTATION, ANALYSIS AND INTERPRETATION

MAJOR FINDINGS (Preview)

The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that pregnant women in Ekpan Community have a high level of knowledge toward antenatal care services, as evidenced by mean scores ranging from 2.17 to 4.45, with most of the positive knowledge statements scoring above the acceptance benchmark of 2.50. This implies that pregnant women generally understand the importance of antenatal care in monitoring maternal and foetal health, detecting pregnancy complications early, taking prescribed supplements, receiving health education, and accessing preventive services.

ii. The study found that antenatal care services are widely utilized among pregnant women in Ekpan Community, as evidenced by mean scores ranging from 2.29 to 4.19, with most utilization statements scoring above the acceptance benchmark of 2.50. This implies that pregnant women generally register for antenatal care early, attend clinics as scheduled, take prescribed medications, utilize health education, and complete recommended visits, although some barriers to consistent utilization may remain.

iii. The study found that pregnant women in Ekpan Community have largely positive attitudes toward the utilization of antenatal care services, as evidenced by mean scores ranging from 2.00 to 4.39, with positive attitude statements scoring above the acceptance benchmark of 2.50 and negative attitude statements falling below it. This implies that pregnant women generally recognize the importance of antenatal care for safe delivery, express willingness to attend clinics, demonstrate confidence in healthcare services, and feel respected by healthcare workers.

iv. The study found that educational background, spousal support, previous healthcare experiences, media information, transportation costs, cultural beliefs, and distance to health facilities influence the knowledge and attitudes of pregnant women toward antenatal care in Ekpan Community, as evidenced by mean scores ranging from 2.50 to 4.29, which met or exceeded the acceptance benchmark of 2.50. This implies that improving maternal health education, strengthening partner support, addressing cultural misconceptions, and reducing transportation and access barriers could enhance antenatal care utilization and maternal health outcomes in the community.

CHAPTER FIVE:  SUMMARY, CONCLUSION AND RECOMMENDATIONS

This chapter covers the following outline:
5.1 Discussion of Findings

5.2 Implications of the Findings

5.3 Limitations of the Study

5.4 Summary

5.5 Conclusion

5.6 Recommendations

5.7 Suggestion for Further Studies

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