Table of Contents
Declaration ............................................................................................................................................................................i
Approval ..............................................................................................................................................................................iii
Dedication ........................................................................................................................................................................... iv
Acknowledgement.................................................................................................................................................................v
List of Acronyms.................................................................................................................................................................. vi
Definition of Terms.............................................................................................................................................................vii
List of Figures.........................................................................................................................................................................x
List of Equations.................................................................................................................................................................. xi
Abstract.............................................................................................................................................................................xiii
CHAPTER ONE: INTRODUCTION ................................................................................................................................................1
1.0 General Introduction...................................................................................................................................................... 1
1.0 Background..................................................................................................................................................................... 1
1.2 Problem Statement........................................................................................................................................................ 3
1.3 Objective of the Study.................................................................................................................................................... 4
1.3.1 Broad Objective........................................................................................................................................................... 4
1.3.2 Specific Objectives....................................................................................................................................................... 4
1.4 Research Questions........................................................................................................................................................ 4
1.5 Study Justification........................................................................................................................................................... 5
1.6 Scope of the Study.......................................................................................................................................................... 5
1.7 Conceptual Framework .................................................................................................................................................. 6
1.7.0 Conceptual frame work............................................................................................................................................... 6
CHAPTER TWO: LITERATURE REVIEW .......................................................................................................................................7
2.0 General Introductions .................................................................................................................................................... 7
2.1 Attendance of ANC visits................................................................................................................................................ 7
2.2 ANC services utilization.................................................................................................................................................. 9
2.3 Socio demographic factors and ANC Utilization .......................................................................................................... 11
2.4 Factors for ANC utilization............................................................................................................................................ 12
2.5 Factors associated with inadequate ANC utilization.................................................................................................... 13
CHAPTER THREE: METHODOLOGY...........................................................................................................................................15
3.0 Introduction.................................................................................................................................................................. 15
3. 1 Study Design................................................................................................................................................................ 15
3.2 Study Setting................................................................................................................................................................. 15
3.3 Study Population .......................................................................................................................................................... 15
3.4 Sample Size Determination.......................................................................................................................................... 16
3.5 Sampling Procedure ..................................................................................................................................................... 16
3.6 Selection criteria........................................................................................................................................................... 17
3.6.1 Inclusion Criteria........................................................................................................................................................ 17
3.6.2 Exclusion Criteria ....................................................................................................................................................... 17
3.7 Definition of Variables.................................................................................................................................................. 17
3.8 Research Instruments................................................................................................................................................... 17
3.9 Data Collection Procedures.......................................................................................................................................... 18
3.10 Data Management...................................................................................................................................................... 18
3.11 Ethical Considerations................................................................................................................................................ 18
3.1 2 Limitations of the study............................................................................................................................................. 19
CHAPTER FOUR: STUDY FINDINGS...........................................................................................................................................20
4.0 General Introductions .................................................................................................................................................. 20
ix
4.1 Study Findings .............................................................................................................................................................. 20
4.1.1 Demographic Characteristics .................................................................................................................................... 20
4.1.2 Proportion of Mothers who attended all ANC visits................................................................................................. 22
4.1.3 Timing of ANC visits................................................................................................................................................... 23
4.1.4 Reasons for Early visit to the ANC clinic.................................................................................................................. 27
Table 7: Reasons for late and early coming ....................................................................................................................... 27
1.4.5 Place of Delivery........................................................................................................................................................ 28
CHAPTER FIVE: DISCUSSIONS ...........................................................................................................................................30
5.0 General Introductions .................................................................................................................................................. 30
5.1 Discussion..................................................................................................................................................................... 30
5.2 Conclusion .................................................................................................................................................................... 33
5.3 Recommendation......................................................................................................................................................... 33
REFERENCES..................................................................................................................................................................................34
APPENDICES..................................................................................................................................................................................38
Appendix 1: Data collection tool........................................................................................................................................ 38
Appendix 11: Consent Form............................................................................................................................................... 42
Appendix I11: Work Plan.................................................................................................................................................... 43
Appendix: IV Research Budget........................................................................................................................................... 44
Appendix V: Map of Kiryandongo district.......................................................................................................................... 45
Appendix VI: Introductory Letter................................................................................................................................... 46
Appendix VII: Recommendation Letter.......................................................................................................................... 47
Abstract Background: In Kiryandongo district, about 38% of the mothers stay at least 5kms away from an ANC clinic with low access to general health care services. This prompted the researcher to investigate the utilization of ANC services among women staying within Kiryandongo town with the objectives: To determine the level of ANC services utilization among women (15- 49) years whether pregnant or was once pregnant and attended ANC clinic in Kiryandongo district. Methods: A cross sectional descriptive and qualitative study was conducted in Kiryandongo town council, Kiryandongo district in western Uganda, between October 2017 and March 2018. The study used a structured self-administered question to interview 390 mothers 15 – 49 years old who attended at least one ANC services in the last years. The mothers were systematically selected. Results: The study enrolled 390 mothers into the interviews, most of who were 25-29 years old (31.5%), the median age for the mothers were 30-34 years, and most were Protestants (28.4%). The study found that 87.6% of the mothers had attended all the ANC services in the last pregnancy, and most of them, 58.2% attended their ANC visit between 1 – 3 months of pregnancy. A chi square test of significance was conducted to determine early attendance of ANC service and the results showed that gravidity was the only significant variable (p value < 0.05) associated with early timing of ANC visits. Multiple response analysis showed that other factors associated to coming early for ANC visit was because they wanted to have a file and history of having a good previous experience in the clinic. Conclusions: The study concluded that the utilization of the ANC services in Kiryandongo town was fairly good as most women (15-49) age group attended ANC clinics, however this was well observed in the early pregnancies as opposed to the late pregnancies. Therefore there is still need for mothers to be sensitized more about the goodness of ANC services. Recommendations: This study recommends that: 1) the community leaders within should mobilize the local communities especially mothers of reproductive age to utilize the ANC services from a formal health center or hospital. 2) Create awareness of the increased ANC services to women of reproductive age in the Town council. And 3), another study of a similar setting with a larger scope should be undertaken to determine the factors causing late attendance xiv of ANC clinics among women of reproductive age at Kiryandongo Town, and follow up the complication associated to mothers attending less ANC services.
