A Study On The Knowledge and Awareness of Antenatal Care Among Women Attending The Antenatal Clinic at Kericho County Referral Hospital
A Study On The Knowledge and Awareness of Antenatal Care Among Women Attending The Antenatal Clinic at Kericho County Referral Hospital
ONUNGA ANTHONY
MS/00032/013
I, the undersigned do declare that this is my original work done during my fifth year of study and
has not been presented by persons known to me for the purpose of examination or otherwise
Signature …………………………………………………….
Date ………………………………………………………......
DECLARATION BY SUPERVISORS
Signature……………………………………………………..
Date …………………………………………………………
ACKNOWLEDGEMENT
I would like to thank God for His immense grace upon me during the research.
I would also like to acknowledge the following people who facilitated the realization of the
Team members (Mose Brian, Kipkirui Herold, Ntadimu Festo, Okoside Leah and Ngode
Fridah)
Supervisors- ( Dr. Muruka Kays, Dr. Wilson Okumu Prof. Ng’wena Magak )
Research respondents
ABSTRACT
This study was carried out to determine the knowledge and awareness on Antenatal care among
women attending the ANC at Kericho County Referral Hospital (KCRH).
Objectives: Objectives of the study were to assess the awareness on the importance of antenatal
care; to determine the factors that influence the women to visit the ANC and to determine how
maternal age influences ANC attendance.
Study Design A descriptive study design was utilized and a cross sectional sampling technique
was used. A structured questionnaire was tool for data collection. Study population were the
women attending ANC at KCRH. 50 subjects were used for the study.
Findings: The findings revealed that majority of the respondents (80%) were below the age of
25 years. 94% of the respondents demonstrated good knowledge and awareness on the
importance and general principles of antenatal care. The reason for seeking antenatal care was to
start regular checkups for 67% of the respondents. 26% of the respondents came to the ANC
because of sickness and 8% were advised by third parties.
Conclusion: Majority of the pregnant women who attended ANC were below 25 years. The
main factor that influenced the women to attend ANC was to start or continue their regular
antenatal clinic visits. Majority of the women were aware of the services offered at ANC and the
importance of clinical procedures undertaken
Recommendations: The facility should hold regular education to the ANC stuff members. To
the county and sub county health authorities, it was recommended that education should be
carried out at the community level on the importance of antenatal health care and on
complications of pregnancy and how to stay healthy in pregnancy.
CHAPTER 1: INTRODUCTION
undertaken during the fifth year of the Bachelor of Medicine and Bachelor of Surgery degree. It
offers the students the opportunity to apply theory and skills we have learnt during the past 4
years. It also helps incorporate the administrative component of the course on Health
Kericho County is located in the central rift of Kenya. It borders Uasin Gishu county to the
North, Baringo County to the North East and Nandi to the North West, Bomet to the South and
Kisumu to the West. The county covers 2,499 square Kilometers. Administratively the county is
subdivided into 5 sub counties: Kericho East, Kericho West, Kipkelion East, Kipkelion West,
Bureti and Sigowet. The total population of kericho county is estimated at 591,000 and the
projected estimate by 2030 at 917,950. The age distribution is as follows: 0-14 years 43.9% 15-
There are a total of 136 health facilities spread across the county with three level 4 two level 3,
12.4% of children are born underweight, 62% of the deliveries were done in a health facility and
62% of children between [12-23 months] had received immunization accordance to the KEPI
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195,856 people tested for HIV, 10,068 are on ARVS and the mother to child transmission rates
The number of health personnel at Kericho county public health facilities is as follows: Nurses
43 per 100,000 people, 15 clinical officers per 100,000 people and 7 Doctors per 100,000 people.
Pregnancy is one of the most important events in the life of every woman and it is also a
dynamic process in which a woman’s risk status can change at any point in time (WHO, 2000).
The government has been doing a lot in ensuring that pregnant women are healthy and this has
led to countrywide campaigns aimed at achieving this. Health institutions have Antenatal Care
Sections which provide antenatal care to the pregnant women and are also supposed to prepare
the expectant mother for the birth and care of the baby. Several procedures are undertaken at the
ANC when offering healthcare to the pregnant women and these includes administration of
drugs, taking laboratory samples and education on staying healthy during pregnancy.
The dispensation of ANC services is good for the health of the mother and the growing fetus.
However, it is not only the duty of the service provider to understand the services being offered
at the ANC. The pregnant women attending the clinic should also understand the rationale of the
clinical processes. A study by Jackoniah and Tammerman (2002) showed that women in Kenya
had a poor understanding of problems associated with pregnancy and this shows that they need
Women are supposed to attend ANC during pregnancy. There are factors that will influence
whether they attend the antenatal clinic and how many times they do it in the course of the
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pregnancy. Such factors could include traditional beliefs, maternal age, level of education and
1.4: JUSTIFICATION
This study will provide detailed information on the understanding of antenatal care among
pregnant women attending the antenatal clinic at Kericho County Referral Hospital. This will be
of benefit to the women attending the clinic, the health facility and the policy makers. In gauging
the level of knowledge and awareness of the ANC service, the hospital and the community health
workers can work on ways to improve their service dispensation and orgnise for awareness
campaigns. The policy makers will find this useful in coming up with policies that are aimed to
make the pregnant stay healthy and go through all the procedures of antenatal care.
Health promotion programs focusing on the wellbeing of pregnant mothers are a major concern
for the government and the other stakeholders such as health workers and the non-governmental
organizations aligned to this sector. This has gone a long way in decreasing the mortality rate
during birth and in promoting good health among the pregnant mothers.
As with all other medical procedures, it is ideal for the patient to understand why they have to go
through the antenatal clinic and get subjected to a number of procedures. It is in line with this
that I sought to find out if the women attending ANC at KCRH understand why they have to go
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CHAPTER 2: OBJECTIVES
2.1: BROAD OBJECTIVE
To assess the knowledge and awareness on the ANC services among pregnant women
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CHAPTER 3: RESEARCH METHODOLOGY
3.1 Study design
The study adopted a descriptive study design aimed at assessing the knowledge on the antenatal
care.
The study will be conducted at the ANC section of Kericho County Referral Hospital.
A cross-sectional study was undertaken to assess the knowledge, awareness, and practices
regarding ANC among pregnant women attending the antenatal clinic at KCRH from Jan to
Feb 2019.
The instrument for data collection is a well-structured questionnaire with open and close ended
questions.
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3.6 Data Analysis
The data collected was analyzed using excel 2013. The data presentation was done using charts,
Permission to conduct the research was sought from the hospital administration before the
research was carried out. The participants were assured of treating the information given with
Time constraint
Resource constraint
Language barrier
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CHAPTER 4: FINDINGS
PART 1: BIO DATA:
Table 1: Age of respondents
Age Frequency Percentage
Below 25 40 80
Above 25 10 20
According to table 1 above, the number of women who were above the age of 25 were 20% of
Of the respondents, 52% studied to college/university, 28% have their highest level of education
Among the respondents, 52% were employed and 48% were unemployed, as shown in table 3
above.
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PART II: INFORMATION ON ANTENATAL CARE UTILIZATION
Table 4: Reason For ANC Visit
Reason For ANC Visit Frequency Percentage
Sickness 13 26
Advised by third parties 4 8
To Start/Continue Regular Checks- 33 66
up
Table 4 above illustrates that 66% of the respondents were coming to the clinic to start or
continue their regular ANC checks. 8% Were advised by third parties and 26% came because
According to Table 5 above, 60% of the respondents chose to come to KCRH because it offers
quality service and 33% chose it over others because it is inexpensive. 20% preferred KCRH
Yes 34 68
No 16 32
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Table 6 Above illustrates that 68% of the respondents confirmed that they had received
education on complications that could arise during pregnancy. 32% said they hadn’t been
Yes 45 90
No 5 10
90% of the
respondents said they had received education on nutrition during their ANC visits whereas 10%
Yes 25 50
No 25 50
Yes 12 24
No 38 76
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According to table 9 above, 77% of the respondents said they hadn’t planned where they were
going to give birth. Only 23% affirmed that they had already made plans on where they would
deliver their babies.
27 25 50
20-26 22 44
<20 3 6
Among all the participants, 50% managed a score of 27 out of 27 and 44% scored between 20
and 26. 6% of the respondents had a score of less than 20.
SUMMARY OF THE MAJOR FINDINGS
Majority of the respondents in this study were below the age of 25 years (80%).
All the respondents were Christians.
53% are educated to the college/university level.
The reason for the ANC Visit was to start or continue regular checkups for 67% of the
respondents.
60% of the respondents chose KCRH because it offers quality service.
67% of the respondents have been educated on the complications of pregnancy and 90%
have received education at the ANC on nutrition during pregnancy.
77% of the respondents haven’t planned with the antenatal clinic on the place of delivery.
94% of the respondents demonstrated good level of knowledge and awareness of
antenatal care.
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CHAPTER 5: DISCUSSION
The discussion of major findings was done in line with the set objectives.
Objective 1
To determine factors that influence the pregnant women to visit the ANC.
From this study to determine the knowledge and awareness of antenatal care among pregnant
women visiting the ANC clinic at KCRH, it was found that the factors that influenced them to
come to the clinic were to start or continue with their ANC check ups (66%), due to sickness
(26%) and advice from third parties (8%). From this study, it is evident that majority of the
population know that they need to go through antenatal care. This is different from what
Karoline, Jackoniah and Temmerman (2006) found when doing a study in Nairobi, Kenya on
what factors influenced pregnant women to seek healthcare. In their study, they found that it was
the level of education that influenced whether pregnant women will seek care.
In a study in Kilifi county by Chorongo et al. (2016), 49.6% of the participants walked a distance
of upto 2 hours to reach the health facility and 60% of the respondents had complains on the
In the study area, which is Kericho in this case, the fact that majority of the pregnant women
know that they need to be attending ANC for regular checks can be attributed to the efforts put in
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Objective 2
To assess the awareness of women attending Antenatal clinic at KCRH on the importance
of ANC.
To assess the level of awareness of the pregnant women attending ANC at KCRH, a scoring
system was developed. There were questions with a maximum score of 27. The questions were
meant to find out whether the women recognized the necessity of antenatal care and if they
understood the components of antenatal care and their significance. 94% of the respondents score
20 and above and 8% scored below 20. This means that majority of the pregnant women
attending ANC understand the importance of the clinical procedures they have to go through.
These findings are in agreement with a study carried out in Metekel in Ethiopia where the
researchers found that 65.6% of the participants were found to be knowledgeable on the
importance of ANC. Another study in North West Nigeria by Igbokwe (2012) also revealed that
74.6% of the participants knew and understood the importance of attending antenatal clinic.
Chorongo et al. (2016) in a study in Malindi and Magarini in Kilifi County found out 91.6% of
the respondents displayed great levels of awareness on antenatal care. This is in line with the
findings in Kericho for this study and it can be attributed to the public education that has been
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Objective 3
In this study, 80% of the mothers were below 25 years of age. Only 20% were above 25 years.
From these figures, it shows that the young women are more likely to attend antenatal clinic. In a
similar study by Nkeita-Amposah et al (2013), the findings were similar. Younger women were
found to be more likely to attend antenatal care at health facilities because they didn’t have any
information or prior education and they were also curious. Low et al. (2005) found that older
women were more lax on the idea of attending ANC because they had prior knowledge and wuld
mostly come late into the pregnancy. This partly explains the level of enthusiasm among the
young women (below 25 years) who constituted a larger part of the correspondents in this study.
However some studies have found out that the older women are more likely to attend ANC and
utilize the antenatal services provides. Birmeta et al (2013) while doing a study in Central
Ethiopia found that pregnant women between the ages of 25-30 were 1.2 times more likely to
attend antenatal clinic compared to younger women. Tran et al.(2013) found that women aged 25
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CHAPTER 6: CONCLUSION
Based on the findings, the researcher concluded that: majority of the pregnant women who
attended ANC were between 19-25 years old. The main factor that influenced the women to
attend ANC was to start or continue their regular antenatal clinic visits. Majority of the women
were aware of the services offered at ANC and the importance of clinical procedures undertaken.
CHAPTER 7: RECOMMENDATIONS
Based on the findings of the research, these are the recommendations put forward.
To The Facility:
seek healthcare.
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REFERENCES:
1. Ali SA, Dero AA, Ali SA, et al. Factors affecting the utilization of antenatal care among
2. Berhe KK, Welearegay HG, Abera GB, et al. Assessment of antenatal care utilization and
its associated factors among 15 to 49 years of age women in Ayder Kebelle, Mekelle City
2014;2(1):62–75
utilization in Holeta town, central Ethiopia. BMC Health Serv Res. 2013;13:1.
4. Chorongo, Fredrick Majiwa Okinda, Eric Jimmy Kariuki, Emily Mulewa, Fredrick
Ibinda, Samuel Muhula, George Kimathi, Richard Muga: Factors influencing the
utilization of focused antenatal care services in Malindi and Magarini sub-counties of
Kilifi county, Kenya: Pan Afr Med J. 2016; 25(Suppl 2): 14. Published online 2016 Nov
26. doi: 10.11604/pamj.supp.2016.25.2.10520
Nsukka local government area of Enugu state, Nigeria. Journal of Research in Education
antenatal care attendance by mothers of Pacific infants living in New Zealand. NZ Med J
2005
7. World Health Organization (2000). Population reports; issues in World Health Semesl; 9,
2010.From:http://www..who.org/populationreports/issuesinworldhealth/9/476872115678
.html
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ANNEX
1.
Greetings,
I am conducting a study on maternal Knowledge and Awareness of Antenatal Care Among Those
Attending Antenatal Clinic At Kericho County Referral Hospital. You are kindly requested to be
included in the study, which will have importance in improving maternal and child health services.
The interview will take not more than thirty minutes. No information concerning you, as an
individual will be passed to another individual or institution without your agreement.
a
Muslim………………2
Christian………….….3
Others…………….….4
b
YES No
10. Did you receive advice on : 1 0
THE END
2. WORK PLAN
c
MASENO UNIVERSITY SCHOOL OF MEDICINE.
REFERRAL HOSPITAL
1.1 Students
1.2 AIM
d
To expose ourselves to the practical aspect of the overall health care services delivery system
in the county.
1.3 OBJECTIVES
MANAGERIAL/ADMINSTRATIVE ACTIVITIES
1. To learn the various county health and hospital administrative structures and
functions.
2. To learn and assess the effectiveness and efficiency of the county referral system.
e
4. To rotate in the following hospital offices/departments
i. Medical super-intendant
county/hospital
1.4 TIMETABLE 1.
f
Orientation in wards and
Outpatient department
Tuesday Meeting with the SCMOH, Research/Discussion
SCPHO, SCCO
Outpatient dept.
Wednesday Research/Discussion
1.5 TIMETABLE 2.
g
WEEK ONE- Orientation at the Hospital and County Health Offices
WK 2-3 WK 4-5
SURGERY/OB INTERNAL
THE END