Maternal health seeking behaviour and pregnancy outcome in rural communities in enugu, state, southeast Nigeria

Background: Antenatal clinic attendance by pregnant women and utilization of skilled health care providers at delivery is still issues of major concern in developing countries including Nigeria. Nigeria Demographic and Health Survey (2013) noted that only 18% of pregnant women had their first antenatal clinic visit in the first trimester of pregnancy while 34% did not receive any antenatal care at all. The report also showed disparity between urban dwellers (23%) and (15%) rural dwellers with reference to antenatal clinic attendance in the first trimester of pregnancy. The choice of place for antenatal care and delivery, to a large extent influence pregnancy outcome for both mother and baby. Thus, positive maternal health seeking behavior contributes significantly to the reduction of the high morbidity and mortality associated with pregnancy and child birth especially in rural communities, of most developing countries. Objective: The aim of the study was to assess maternal health seeking`behaviour and pregnancy outcome in rural communities in Enugu State in order to provide evidence based information for effective health education for the study population. Methods and Materials: TheCross-sectional descriptive survey design was used for the study. Validated researcher developed questionnaire and observation guide were the instruments used for data collection. Descriptive and inferential statistics were used to analyze data obtained using SPSS version 20 at 0.05 level of significance. Results: Majority of the respondents 165 (79.7%) booked for antenatal care during the first trimester of pregnancy, and 193 (93.2%) attended antenatal care in a health facility while only 7 (3.4%) did not attend antenatal care in a health facility nor visited a traditional birth attendant home. The study further revealed that 100 (48.3%) of the respondents attended secondary health care facilities (General Hospital) while 74(35.7%) attended primary health care facilities which were located within the communities. Out of the 207 pregnant women studied, 141 (68%) had health problems associated with pregnancy and all of them visited a secondary health care facility for treatmentwhile only 42 (20.3%) visited a primary health care facility.Most of the mothers 172(83%) carried their pregnancies to term and had safe delivery. They were also healthy to take care of their babies while 35 (16.9%) were weak for self-care and care of their babies at birth. They however, gradually regained strength within one week postpartum. Baby’s outcome was good, 175 (84.5%) cried vigorously at birth, 31 (15%) had weak cry one minute at birth but picked up at 5 minutes after birth, however one baby 1 (0.5%) was stillborn. Age and educational level of respondents did not significantly influence their health seeking behaviour (p>0.05). But pregnancy outcome for baby and place of antenatal care showed significant association (p<0.05). Conclusion: The study concluded that maternal health seeking behaviour in the rural communities studied in Enugu was good as revealed in the positive pregnancy outcome for most of the mothers and their babies.However it was intriguing to find out that primary health care facilities which were located within the communities were poorly utilized by the mothers for antenatal care and delivery while secondary health care facility located at some distance from their homes had better patronage. It was therefore recommendedthat there is need to identify factors that hinder the use of primary health care facilities by pregnant mothers in the studied population and such factors should be addressed for better utilization by these rural women.