Awareness and Acessibility of ANC among the obstetric patients in CMCH (2018), a journal review

1. Awareness and Accessibility
of ANC among obstetric
patients admitted in
CMCH

2. Introduction
Women in developing countries were experiencing life threatening and other
serious health problems related to pregnancy or childbirth. This situation was
worse in developing countries like Bangladesh due to unawareness and
inaccessibility. Then It was adopted in Bangladesh following the world summit
for children in 1990 considering ANC as a specific goal for comprehensive
maternal health care. It is the care that pregnant women should have during her
pregnancy for protection of her and safe delivery. Evidence suggests that
adequate antenatal care use has association with improved pregnancy outcome
both for child and mother.

3. Objectives
• Identify and analyze the main factors affecting awareness
and accessibility of antenatal care.
• Assessing whether awareness to this govt. project
depends on clients or service provider.
• Determine whether the provision of service may be
scanty in quality or quantity

4. Key Variables
General variables
• Age
• Sex
• Occupation
• Educational status of woman
• Address

5. Specific Variables
• Socio-economic status
• Educational Status of husband
• Knowledge of ANC
• ANC Frequency
• Barrier in getting ANC
• Vaccination
• Proposed MOD
• Economic status affecting ANC

6. Operational Definitions
• Awareness
knowledge that something exists, or understanding of a situation or subject at
the present time based on information or experience
• Accessibility
the availability of good health services within reasonable reach of those who
need them and of opening hours and other aspects of service organization
• ANC
care provided by skilled health-care professionals to pregnant women in
order to ensure the best health conditions for both mother and baby

7. Methodology
• Type of study
descriptive type of cross-sectional study.
• Place of study
Ward 31,33, 34
• Time of study
08 am – 2.00 am on November 2,2018
• Study population
20 -45 years aged women
• Sample size
100 Respondents

8. • Sampling technique
Convenient type of non-probability sampling
• Research instrument
Prepared pretested mixed type of questionnaire
• Ethical consideration
After introductory conversation, informed verbal consent was taken from
the respondents.
• Method of data collection
We collected data by face to face interview conducted by 5 doctors.

9. • Data compilation and analysis
data were analyzed manually with the help of calculators, computers.
Results are presented by tables and graphs
• Inclusion criteria
People who has given consent to participate
• Exclusion criteria
People who were not present those who could not respond and haven’t given
consent

10. RESULTS

11. 0%
10%
20%
30%
40%
50% 43%
27%
17%
10%
2%
Age distribution
20-25 26-30 30-35 36-40 41-45

12. Education Vs ANC knowledge
Educational status ANC knowledge
YES NO
Illiterate 80% 20%
PSC 83% 17%
JSC 85% 15%
SSC 92% 8%
HSC 100% 0%
Graduate 100% 0%

13. 2%
29%
69%
Upper Class Middle Class Lower Class
Socio Economic Score

14. Educational Status of Husband
Illiterate
Below SSC
SSC
HSC
Honors
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Illiterate Below SSC SSC HSC Honors

15. 83%
17%
High Risk Pregnancy
YES
NO

16. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
1
89%
12%
YES NO
Do you know what is ANC?

17. 0% 10% 20% 30% 40% 50% 60%
1
2
3
4
>4
ANC Visiting Frequency
10%
2%
30%
55%
3%

18. 39%
61%

19. Media
3%
Satellite Clinic
3%
Outreach Centre
1%
Community Clinic
26%
Doctor
37%
Others
30%
Sources from they knew about ANC

20. 0% 10% 20% 30% 40% 50% 60% 70% 80%
1
Awareness about danger sign of ANC
30%
70%
YES
NO

21. 40%
47%
7% 6%
Knowledge Gap Reluctancy Lack of
Preference
unavilability of
health facility
Barriers of getting ANC

22. 81%
19%
TT Vaccination during ANC
YES
No

23. Y
E
S
N
O
63% 37%
YES NO
Counseling about family Planning

24. NVD
55%
LSCS
45%
Mode of delivery
NVD LSCS

25. Awareness Vs Hindrance
Lack of Accessibility Awareness
YES NO
Reluctancy 78% 0%
Knowledge Gap 0% 100%
Lack of preference 11% 0%
Unavailable health facility 11% 0%

26. Limitations
• Due to time constraints proper rapport with the patient
was not possible
• Due to shortage of time sample size was smaller
• Shortage of manpower was critical
• Other important aspects were not included in the
questionnaire due to time constraints

27. Recommendations
• Female education must me ensured in the rural aspects of the
country
• Expanded media coverage for ANC to improve the outcome
reproductive health in the outskirt of the country
• Wider availability ANC services in the grass-root level
• Safe transport facility for pregnant women to reach ANC

28. Conclusion
• It is conspicuous that having ANC knowledge is higher (100%) in the educated
than illiterate (80%) and education made a difference
• 85% of people have minimum knowledge about WHO recommended 4 ANC
visits whereas 15% were ignorant.
• Doctors have the maximum (37%) contribution in spreading about ANC in
contrast to media coverage of 3%
• Knowledge gap has the highest role for not taking ANC whereas unavailable
health facility was the least concern of all
• About 20% women have not prior knowledge of birth plan

29. • Those who went for ANC was almost able to find a doctor and and
routine investigations at the facility
• There was 100% coverage of vaccinations for women who went for
ANC even for once.
• Iron , folic acid and vitamins were taken by 100% women who went
for ANC
• Due to proper ANC the rate of caesarean section was seem to drop to
45%
• For 60% of pregnant women, economic burden was not an
impediment in receiving ANC

30. Bangladesh
has won MDG
award in 2015
, now heading
towards SDG

31. Thank You
on behalf of
• Mostofa Sarwar
• Mohammad Yeasin
• Md. Omar Faruk
• Nafiz Saadman Ahsan
• Md. Zahirul Islam