THE EFFECTS OF SOCIO ECONOMIC FACTORS ON THE NUTRITIONAL STATUS OF PREGNANT WOMEN ATTENDING ANTE NATAL CLINIC IN AMUKPE COMMUNITY, SAPELE,L.G.A

 

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CHAPTER ONE

Background of the Study

Nigeria still has an extremely high maternal mortality ratio 704 per 1000000 live births implying that with about 2.4 million live births annually, some 170000 Nigerian women die as a result of complication associated with pregnancy and child birth (Adelakan, Alimi, Anyawale and Afonja, 2005).Women are more likely to suffer from nutritional deficiency than men for several reasons, including their reproductive biology, low social status, poverty and lack of education. In addition, socio-cultural traditions and disparities in household work patterns can also increase women’s chance of being malnourished (Ransom IE, Elder KL, 2003).

During pregnancy a woman  needs good nutritional status for a healthy outcome. Women who have a poor nutritional status at conception are at higher risk of disease and death; their health depends greatly on the availability of food, and they may be unable to cope with their increased nutrient needs during pregnancy in situations of food insecurity. Women’s nutrient needs increase during pregnancy and lactation. Some of the increased nutrient requirements protect maternal health while others affect birth outcome and infant health. If their requirements are not met, the consequences can be serious for women and their infants (Freedom from Hunger, 2003). Under nutrition and poor health from preventable causes disproportionately affect the well-being of millions of people in the developing world. Factors at individual, household and community level, or a combination of these factors, may contribute to poor nutrition and health status (Ronsmans C, Collin S, Filippi V, 2008).  In particular, malnutrition among women is likely to have a major impact on their own health as well as their children’s health. More than 3.5 million women and children under age five in developing countries die each year due to the underlying cause of under nutrition (Ronsmans et al, 2008).

Poverty influences to a great extent the nutritional status of women especially pregnant women. According to Adelakaan e tal (2005), data on mother’s energy intake indicated poverty levels higher than presented in the world bank poverty assessment (world Bank, 2003).

A study in Ibadan by Maclean (2002) on pregnancy and food taboos, it was discovered that pregnant women were warned not to eat large plantains with cleft so as not to have babies with rigid skulls. In Ile-Ife, many traditional healers discourage pregnant women from eating snails or okra soup, as these would harm the babies. Chiwuzie and Okolocha, (2007) discovered that many pregnant women were advised not take milk and egg during their pregnancy that it lead to their babies growing up to be a thief.

Thus the researcher is keen to determine the effects of socio economic factors on the nutritional status of pregnant women attending Ante natal clinic in Amukpe community, Sapele,L.G.A

 

Statement of problem

Maternal complications during pregnancy has been of the major challenge faced by most pregnant women as a result of poor nutrition, thus most pregnant women are posed with various risks and complications during pregnancy. The condition may be caused by a variety of reasons. The affluent society that we are a part of is very concerned with the thinness of women; thus, many women starve themselves or undergo feed diets to maintain this image. Some women suffer from psychological eating disorders such as anorexia nervosa or bulimia. Age will influence the woman’s dietary practices; if the pregnant woman is an adolescent, she will probably consume many “Fast foods” which will not provide adequate nutrients and the eating of native chalk and drink of alcohol. Thus the researcher is keen on determining the socio economic factors and effect on the nutritional status of pregnant women attending Ante natal clinic in Amukpe community, Sapele,L.G.A.

ASSESSMENT OF UMBILICAL CORD CARE GIVEN BY TRADITIONAL BIRTH ATTENDANTS IN OGHARA ETHIOPE WEST LGA NORTH LOCAL GOVERNMENT AREA

 

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1. Access Bank:
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2. EcoBank:
—-*326#

3. Fidelity Bank:
—-*770#

4. FCMB:
—-*389*214#

5. First Bank
—-*894#

6. GTB:
—-*737#

7. Heritage Bank:
—-*322*030#

8. Keystone Bank:
—-*322*082#

9. Sky Bank:
—-*389*076*1#

10. Stanbic IBTC:
—-*909#

11. Sterling Bank:
—-*822#

12. UBA:
—-*389*033*1#

13. Unity Bank:
—-*322*215#

14. Zenith Bank:
—-*966#

15. Diamond Bank
—-*710*555#

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—-*565*0#.

E.g for First bank…   *894 *Amount *Acct. No. #

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08074466939 or 08063386834, YOUR PROJECT TITLE  YOU WANT US TO SEND TO YOU, AMOUNT PAID, DEPOSITOR NAME, UR EMAIL ADDRESS,PAYMENT DATE. YOU WILL RECEIVE YOUR MATERIAL IN LESS THAN 2 HOURS ONCE WILL CONFIRM YOUR PAYMENT.

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CHAPTER ONE—————————————————————————1

INTRODUCTION—————————————————————————–1

Background of study———————————————————————-1

Aim/Purpose of study——————————————————————–2

Statement of problem———————————————————————3

Broad objective of the study————————————————————-3

Specific objective————————————————————————3

Significance of study——————————————————————–3

Scope of study / delimitation ———————————————————-3

Operational definition of terms——————————————————–4

CHAPTER TWO

Literature review—————————————————————————5

Conceptual framework——————————————————————-22

Hypothesis ———————————————————————————24

CHAPTER THREE

MATERIALS AND METHODS

Research design————————————————————————–26

Research site and setting—————————————————————-26

Research population ——————————————————————–26

Sample and sampling techniques——————————————————27

Instrument for data collection———————————————————-27

Validity/reliability ———————————————————————–27

Method of data collection—————————————————————28

Procedure for data analysis————————————————————-28

Ethical consideration——————————————————————–28

CHAPTER FOUR

RESULT———————————————————————————–29

Data analysis and interpretation———————————————————30

Testing of hypothesis———————————————————————-41

CHAPTER FIVE

DISCUSSION OF FINDINGS————————————————————44

Discussion of findings———————————————————————44

Nursing implication————————————————————————46

Summary ———————————————————————————–47

Conclusion———————————————————————————-47

Recommendation—————————————————————————47

References ———————————————————————————49

Appendix ———————————————————————————-52

                                                      ABSTRACT

Proper care of the umbilical cord is very important to avoid sepsis in the life of the neonates. This study was on Assessment of Umbilical Cord Care given by Traditional Birth Attendants in OgharaEthiope West LGA. 92 open and closed ended structured questionnaires were administered and 82 were retrieved successfully which wereanalyzed to all the TBAs in Oghara community. The findings revealed that 57 (69.51%) of the respondents do not know about cord care while 25 (30.49%) knows of cord care. This Shows that majority of the TBA are not informed on appropriate care of the umbilical area of a new born.. The hypothetical statements was tested using chi-square.  A theoretical value of 3.3which was found higher than the computed value which showed that there is significant relationship between the knowledge of TBAs on cord and their practice on cord care. The data analyzed were compared with the empirical works for similarities and dissimilarities; Reasons for Identified dissimilarities were discussed. Based on the findings,  it was recommended that the government should empower the TBAs by providing funds to support them to organize seminars and workshops on relevant  issues that concern their  maternal and child health care.

 

 CHAPTER ONE

INTRODUCTION

 

Background of the Study

Umbilical cord is the lifeline of the fetus and of the neonate in the first few minutes immediately after birth. Care of the cord and stump during neonatal period varies according to the social, cultural, economic and geographical factors. Measures take to ensure sterility in cutting and tying the umbilical cord may prevent cord infection (Mullay, 2005). Clean umbilical cord care is accomplished by the maintenance of aseptic technique so that the umbilical cord is uncontaminated by pathogens.At birth, hands should be washed with clean water and soap before tying and cutting the cord. The newborn should be laid on a clean surface and the cord should be cut with a sterile instrument. In the postnatal period, routine cord care includes washing hands with clean water and soap before and after care and keeping the cord dry and exposed to air or loosely covered with clean clothes. The napkin should be folded below the umbilicus. Touching the cord, applying unclean substances to it and covering it with bandages should be avoided. Every year globally, an estimated 4 million infants die and approximately two-third of all these deaths occur in the neonatal period (NNHS, 2004). A substantial proportion of neonatal deaths from infection are due to cord infections (WHO, 2004). Nepal has one of the highest neonatal mortality ratesin the world which is 34 per 1,000 live births. Neonatal Mortality Rates currently accounts two thirds of all infant mortality (MoHP, New ERA and Measure DHS, 2006).

Since the adoption of the primary health care approach in Nigeria in 1979, the three tiers of government (federal, state and local government levels) have accepted the idea of the need to integrate Traditional Birth Attendants into PHC. TBAs presently deliver majority of women in Nigeria as in other developing countries. It is estimated that between 60 and 80% of all deliveries in the developing countries occur outside modern health care facilities, with a significant proportion of this attended to by TBAs (WHO, 2004). Traditionally African births, including prenatal and postnatal care, take place at home, supervised by at least one older, trusted female member of the family or community.. The influence and acceptability of these females, known as Traditional Birth Attendants (TBAs) continue to exist amongst people in remote rural areas and even when formal health services are available. Thus the evaluation of the care of cord stump by TBA is essential in primary health care (Davies, Yin Nu, Oum and Waisi, 2012)

TBAs cannot, however, be automatically incorporated with western health care. Some authors have observed flaws in the practice of TBAs such as poor hygienic practices and infection control, for example, lack of hand washing, unsafe cutting of the cord threatening the safety of the baby, interference with labour, and harmful traditional practices such as taking oxytocic agents (http://www.mariestopes.org.uk/ case studvl.html; Sahachowdhury, 2009).

Immediately after the baby is born, the cord is cut with an instrument by a Traditional birth attendant using the following; bark of a bamboo or a hard and sharp stalk of a plant, razor blade, two sharp stones between the cord is crushed, scissor, etc. hygienic precautionary measures are not always observed. Traditionally, one of the following materials may be applied to the stump of the umbilical cord, also scraping from a coconut shell, cow dung, ashes from the heart of the stones.etc

Poor care and assessment of umbilical cord by traditional birth attendant have been the major factors causing child mortality after birth, thus the researcher was prompted to carry out a research to determine the assessment of umbilical cord care among traditional birth attendants in OgharaEthiope West L.G.A Delta State