ABSTRACT
The major objective of this research was to examine
the problems and prospects of women and access to reproductive healthcare
services in Dutsin-Ma local government area of Katsina State. The study was
hinged on four major objectives which were to ascertain the state of women
reproductive services, determine whether women have access to reproductive
healthcare services, Identify the challenges facing women access to
reproductive healthcare services and Suggest ways that can enhance women access
to reproductive healthcare services in Dustin-Ma local government area.
Andersen Health Behavioural Model was used as the major theoretical framework
to explain women access to reproductive healthcare services. Questionnaire and
key informant interview were used as the primary instrument of data collection.
The sample size of the study was 110 respondents. Inferential statistical tools
such as tables and percentages were used to analyze the data collected. The
findings of the study indicated that women in Dutsin-Ma are aware of maternal
healthcare services in their areas and they have adequately utilized it. The
study therefore observed that, women in Dutsin-Ma have access to maternal
healthcare services because they are cheaper and affordable. The major
challenges facing women and access to maternal healthcare services were
financial constraints, ignorance, husband’s restriction, not listening to media
sources and socio cultural beliefs of the people. The study therefore
recommended that women should be educated and sensitized with their husbands,
on the importance of maternal care and socio cultural disposition, also women should be empowered, maternal charges
should be subsidized for all and finally
government should bring maternal healthcare services to the door steps of women
building of more maternal health centers and good road networks.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Health
is central to community well-being, personal welfare and has strong influence
on people’s earning capacity. It is fundamental to people’s ability to enjoy
and appreciate all other aspects of life. Health care utilization is use of
healthcare services by people. The healthcare utilization of a population is
related to the availability, geographical access, quality, cost of services,
perceived benefits, as well as to social-economic and cultural structure, and personal
characteristics of the users.(Chakraborty et al., 2003; Onah et al., 2009).The
joys of motherhood is childbearing, it is a source of sorrow to many households
as many women lose their lives during child birth. Every single day, Nigeria
loses about 2, 300 under five years old and 145 women of childbearing age (Federal
Ministry of Health, 2005). Discussions on reproductive and sexual health rights
which had hitherto been a ‘taboo’ in traditional African societies are on the
increase according to African scholars (Aniekwu, 2006). While the right to
health has been an internationally recognized human right, reproductive health
rights gained formal acceptance only in 1993 and the need for women to have
access to quality reproductive health services such as medical care, planned
family, safe pregnancy, delivery care, treatment and prevention of sexually
transmitted infections, such as HIV/AIDS is increasingly gaining recognition in
Africa at large and Nigeria in particular (World Health Organization, 2004).
Despite
this recognition, reproductive health of women is still one of the major health
challenges worldwide particularly in resource-poor countries such as Nigeria.
Women represent a vulnerable population group as a result of biological and
gender-related differences. Reproductive ill-health accounts for 20% of the
global burden of ill-health of women compared to 14% for men (World Health
Organization, 2008).According to Shiffman (2007), the health status of
countries has been assessed using women reproductive health indicators such as maternal
mortality rates, antenatal care coverage, and proportion of delivery supervised
by skilled birth attendants, unmet need for family planning among others. This
clearly underscores the fact that, all efforts must be on deck by both
government and non-governmental organization to ensure that women have access
to reproductive health service. The International Conference on Population and
Development (ICPD) and the Millennium Development Goals (MDGs), both set goals
to reduce maternal mortality and improve access to reproductive health
services. The MDG target number 5 to reduce maternal mortality by three-quarter
and achieve universal access to reproductive health by the year 2015.(World Health
Organization, 2004).
The
current population ofNigeria is 189,689,126 people based on the latest United
Nations estimate. Nigeria population is equivalent to 2.55% of the total world
population (world population prospects, 2015).Abouttwo-third of the population
live in rural areas, and most rural dwellers are involved in the agriculture
sector. Ibrahim, M. K. (2005).
In 2008, the adult literacy rate for both sexes was 74.8%. Nigeria has a high
total fertility rate estimated at 5.5 births per woman (compared to a world
average of 2.5). The fertility preference of Nigerian women is closely related
to the number of living children. Despite the decline in childhood deaths,
fertility rate has reduced partly due to the family planning prevalence rate
and the high unmet need for contraception. (Babalola and Fatusi, 2009). According to latest WHO data published in
2015; the life expectancy at birth was estimated at 54.5 years (WHO, 2015). The
health system in Nigeria is largely driven by the public sector
(Okpani&Abimbola, 2015). The national government’s health expenditure per
capita and budget allocation to reproductive health are low. The healthcare
infrastructures and manpower are grossly inadequate, with most of the available
healthcare resources located in urban areas. Healthcare financing is mainly
through personal income or out-of -pocket payment (World Bank, 2015).
Health
is inaccessible to majority of the population (UNICEF, 2012). Most people
seeking healthcare services patronize traditional healers or unorthodox
healthcare providers. Women in Nigeria face numerous reproductive health
challenges such as an unacceptably high maternal mortality rate (MMR), high
unmet need for contraception, infertility, human immunodeficiency virus (HIV)
and Acquired Immunodeficiency Syndrome (AIDS) epidemic and so on.
Interestingly, wide disparity in women’s reproductive health exists between
different geographical zones within Nigeria due to social, cultural, environmental
and physical factors (Ladipo, 2008).
Until
quite recently, reproductive and sexual rights were considered by most Africans
as issues for discussion only by ‘queers’ and liberal feminist groups (Aniekwu,
2006). The typical traditional African values and societal norms view
reproduction and sexual practices as very private issues not meant for public
discussion. Thus, it was more or less a “sacrilege” to advocate for sexual
rights, safe abortion and reproductive choice.
Cultural
practices like female and genital mutilation (FGM) are accepted by many societies
and the practice is not considered harmful or illegal by many. Many aspects of
reproduction such as safe motherhood and family planning services were not
regarded as ‘rights’ per se (Aniekwu, 2006). It is against this background that
this study seeks to assess the reproductive health care services for women in
Dustin- Ma local Government.
1.2 Statement of the Problem
High
maternal morbidity and mortality rate is a huge public problem in the
developing countries of the world, including Nigeria. The maternal mortality
rate in Nigeria is 630 deaths per thousand live births and Nigeria ranks 10th
position in the World record of health indicators (Criminal Investigation
Agency World Fact book, 2012). With an estimated 52,000 annual deaths, Nigeria
accounts for about 10% of all maternal deaths, globally and has the second highest
mortality rate in the World, after India. It is also reported that, for every
woman that dies from pregnancy-related
causes, 20 to 30 more will develop short- and long-term damage to their
reproductive organs resulting in disabilities such as obstetric fistula, pelvic
inflammatory disease, a ruptured uterus, etc. ( World Health Organization
(WHO), 2007; Shiffman and Okonofua, 2007).
Despite
the existence of national programs for improving maternal and child health in
Nigeria, maternal mortality and morbidity continue to be high and studies
suggests that the majority of maternal deaths can be prevented or reduced if
women have access to or visited maternal health services during pregnancy,
childbirth and the first month after delivery (Dayaratna, 2000; World Health
Organization, 2004; Federal Ministry of Health, 2005).
However,
many women in developing countries do not have access to maternal healthcare
services and it is reported that use of such services remain low in sub-Saharan
Africa including Nigeria (Babalola and Fatusi, 2009); where only 58% of women
have attended at least one maternal clinic during pregnancy, 39% of births are attended
to by skilled professional, 35% of deliveries take place in a health facility
and 43.7% receive postnatal care (World Health Organization, 2012). Darmstadt
GL, Bhutta Z.A., Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal
(2005) are of the opinion that accessibility of health services has been shown
to be an important determinant of utilization of health services in developing
countries. In most rural areas in Africa, one in three women lives more than
five kilometers from the nearest health facility (World Bank2002). The scarcity
of vehicles, especially in remote areas, and poor road conditions can make it
extremely difficult for women to reach even relatively nearby facilities.
Walking is the primary mode of transportation, even for women in labor (World
Bank, 2002). Addai (2000) stated that women in higher socioeconomic groups tend
to exhibit patterns of more frequent use of maternal health services than women
in the lower socioeconomic groups, factors such as education appear to be important
mediator.
This
study therefore seeks to educate/enlighten women on the adequate importance of
family planning services, prevention of sexually transmitted
infections/HIV&AIDS, provide information and routine services for prenatal,
postnatal, safe delivery, prevention of infertility and appropriate treatment,
responsible parenthood against harmful practices and adequate counseling on
women’s reproductive health. The study willassess the challenges and prospects
of reproductive healthcare services for women in Dustin-ma Local Government
Area of KatsinaState.
1.3 Research Objectives
The
main aim of this study is to assess the challenges(s) and prospects(s)of
reproductive healthcare services for women in Dustin-ma local government area. However
Specific objectives of this study are:
1.
Ascertain the state of women reproductive services in
Dustin-Ma local government area.
2.
Determine whether women have access to reproductive
healthcare services in Dustin-Ma local government area.
3.
Identify the challenges facing women access to reproductive
healthcare services in Dustin-Ma local area.
4.
Suggest ways that can be done to enhance women access
to reproductive healthcare services in Dustin-Ma local government area.
TOPIC: ASSESSMENT OF REPRODUCTIVE HEALTHCARE SERVICES FOR WOMEN
Chapters: 1 - 5
Delivery: Email
Delivery: Email
Number of Pages: 90
Price: 3000 NGN
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