Antenatal care practice among Pregnant Women in a selected rural area of Bangladesh

Background : Antenatal care (ANC) is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and newborn babies depend. Objective : To study the Antenatal care practice among pregnant women in a selected rural area. Methodology : This descriptive cross-sectional study was conducted among pregnant women in a selected rural area from July 2016 to December 2016. Total sample was 121. Purposive sampling technique was followed. Data collection was done by face to face interview by using pretested structured questionnaire. Data was analyzed by SPSS version 17.0. Results : A total of 121 women were interviewed. Sixty nine (57.02%) pregnant women were registered for ANC. Among them 47(68.11%) of respondents completed more than 4ANC visits. For the current pregnancy 56(46.28%) preferred Upazila Health Complex (UHC) and home delivery was preferred by 34(28.09%) respondents. Among the respondent age group 25-30 yrs were 61(50.41%) and educated upto primary level were 59(48.76%). Monthly income between 5000-10000 taka was among 48(39.66%) respondents. Most of their husbands (52.06%) were educated up to primary level and 25.61 % of them were garments worker and 23.96 % were day laborers. Conclusion : ANC practice was not satisfactory. Only half of the pregnant women attended for ANC and completed minimum four visits. Nearly half of the pregnant women preferred UHC. Educated women from lower economic status were found to attend for ANC.


Introduction
Antenatal care refers to pregnancy-related health care, which is usually provided by a health provider either in a medical facility or at home. Antenatal checkup is a means to encourage women by the health professionals to deliver in an institution. 1 Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. The necessities of ANC services by explaining the numerous advantages of them which may include monitoring health of the mother and baby during pregnancy, anticipating difficulties at pregnancy and labor with early treatment to reduce the risks for mother and child, facilitating the better use of emergency obstetric care services, disseminating health education and information and so on. The

Original Article
Antenatal care practice among Pregnant Women in a selected rural area of Bangladesh N Begum et al. Regular attending for ANC is a key strategy for reducing maternal mortality, but millions of women in developing countries do not receive it. 5 Therefore, in this study we try to find out the status of antenatal care practice among pregnant women in a selected rural area of our country.

Materials and Methods
This descriptive cross sectional study was conducted among the pregnant women in Srinagar Thana from July 2016 to December 2016. Following purposive sampling technique 121 pregnant women were included and data collection was done by face to face interview by using pretested structured questionnaire and data were analyzed by using SPSS version 17. Written informed consent was taken from the respondents before data collection.

Results
Total 121 pregnant women were selected in the study, among them 61(50.41%) were in the age group of 25-30 years. Educational status of the pregnant women up to primary level were 48.76% and uneducated were 30.57%. Most of the women (73.55%) were house wife. Husbands were educated mostly (52.06%) up to primary level and 25.61% were Garment's worker and 23.96% were day laborer. Monthly income was between 5000-10000 taka among 39.66% families. Number of living children between 1-2 found in 51.23% families and 52.89% pregnant women were living in extended families (Table I)

Discussion
This cross sectional study was done to find out the antenatal care practice among pregnant women. We found that more than half of the women were between age 25 to 30 years, 30.57% had never been to school, but more than one-third 48.76% of respondents attended primary school and 20.66% had secondary and higher education. In this study it was also observed that education level of women is lower than that of their husbands. Similar findings also showed in Haque A study.
On the other hand Martina Eshowed only 10% the women had not been educated. 6,7 In our study it was found that, more than half (73.55%) of the women were housewives and 26.44% engaged in any paid work. This was consistent with another study done in rural area of Bangladesh. 8 Monthly income 5000-10000 taka among 39.66% respondent. The occupation among the husbands of the pregnant women were mostly garment's worker (25.61%)and day laborer (23.96%). Similar result was found in study by F Mahejabin et al. 9 Among the respondents 51.23% had 1-2 living children and 52.89% stayed with extended family. Manas P. Roy, et al found similar result in a study in India. 10 Home delivery of the last child, was found 62 % due to lack of awareness in 22.58% and 25.81% thought high cost in the hospital and for both reasons 40.32%. The similar finding also found in Pokhrel BR study. 11 An interesting finding was that 11.29% respondents were not allowed hospital delivery by the family head. They thought that delivering child at hospital might not be necessary since it is a natural process which is gifted by the God, He Himself will save the life of mother and new born baby.
Regarding TT vaccine majority had taken adequate doses of T.T vaccines. But only a few knew its importance. Also similar findings found by Prakash V study. 12 In present study majority respondents (68.13%) received ANC service from UHC and 68.12% received more than 4 visits. This result was consistent with a study in Pakistan by Z. Fatmi. 13 On asking the place of delivery for current pregnancy 46.28% answered to delivery at UHC and among them 51.3% respondents selected UPH for avoiding pregnancy and delivery related complications. Similar finding was reflected in a study by Niveditha Det al in India. 14 Regarding the reason for selecting UHC for the place of delivery, 51.3% respondents preferred for avoiding pregnancy related complications (Fig -1)