Essay Example on 8 What are the Factors affecting Antenatal Care Use in Pakistan









8 What are the Factors affecting Antenatal Care Use in Pakistan 8 1 Time to visit Antenatal Care A study conducted in Sindh showed that women seeking antenatal care earlier in their pregnancy are more likely to receive WHO recommended standard of care along with increased rate of presence of a skilled birth attendant at the time of delivery This health seeking behaviour was found to be dependant on parity education and household wealth Presence of skilled birth attendant helps reduce maternal mortality and morbidity 8 2 Distrust in Government facilities Men and women both have a general distrust in the government operated healthcare facilities as they are considered to be ill equipped poor behavior of healthcare providers medical services are not available after 2 o'clock lack of family planning services and information especially for men because Lady Health Workers are not comfortable talking to men about Family Planning as dictated by the norms 

Government should try to recruit male reproductive health workers or initiate a program which educates males of reproductive age about their reproductive health 8 3Mothers Chronic Stress Psychosocial stress due to lack of education poor socioeconomic status workload at office busy doing home chores stress of producing a male child unemployed women who had a child with a chronic illness and those with poor coping skills increases the risk of having a low birth weight baby 9 What are the Barriers to receiving Antenatal Care 9 1 Financial Women claim that visits to doctors are expensive which they cannot afford But under Primary Health Care maternal child health programs antenatal health care facilities are freely available at government hospitals 9 2 Individual Lower women autonomy unsupportive family lack of knowledge and education backward beliefs stating that our mothers did it without any extra healthcare so why do we need it perceived absence of any major health problems during pregnancy busy performing household chores 9 3 Organizational Long waiting times at health facilities lack of equipment and medicines tired and unvigilant staff due to work overload leads to lack of utilization of healthcare facilities resulting in unequal quality of services According to Pakistan demographic health survey 

70 of pregnant women did not receive antenatal care 23 receive antenatal care by doctor 3 by nurse lady health visitor or family welfare worker and four percent by trained or untrained traditional birth attendant which shows only a small number of women seek antenatal care many of theses have poor outcome due to the uneven quality of services 9 4 Structural Poor infrastructure lack of public transport and increased commute time 10 What are the New interventions to Augment Antenatal Care 10 1 Antenatal steroid therapy for women in preterm labour This mode of treatment can save upto 500 000 neonatal deaths per year A thirty one percent reduction in preterm neonatal mortality and thirty four percent reduction in respiratory distress syndrome was reported in a Cochrane review Given the high potential to save lives the low cost and the apparent feasibility in low resource settings the current low coverage of antenatal steroids represents a major missed opportunity says Unicef's report on Country Regional and Global estimates of Low birth weight 10 2 Neonatal resuscitation

Neonatal resuscitation and primary prevention through obstetric care could help reduce loss of 190 000 lives per year attributed to mortality related to intrapartum neonatal deaths and preterm babies Several low income countries have made progress towards neonatal resuscitation by training midwives and adding it to the curriculum of medical teaching institutes 10 3Postnatal care Postnatal care refers to first six weeks after birth leading to first immunisation visit for newborn and family planning visit for mother This initial period is considered a golden time to increase breast feeding practice educating cord cleaning habits keeping babies warm especially premature babies Kangaroo mother care is the method of skin to skin contact for preterm babies to keep them warm Postnatal packages were implemented in several Asian settings like Pakistan and India with the objective of enhancing community mobilisation and care seeking behaviour Success of this package helped African countries to develop postnatal packages for their health systems 

Unicef s report on Country Regional Global estimates of Low birth weight showed a 20 decrease in neonatal mortality in a one year pilot study conducted in Pakistan 10 4 Miscellaneous Solutions Strengthen neonatal interventions Effective intrapartum care Immediate newborn care Case management of Integrated Management of Childhood Illness IMCI Conclusion Motivating women to make an early first ANC check up along with iron folic acid combined supplement hygiene maintenance proper neonatal feeding and temperature maintenance can reduce maternal mortality and morbidity Such a focus is most likely to benefit the poorest least educated and highest parity women even if they receive ANC in the last trimester There is also a need to improve information education and communication efforts Information about better nutrition use of contraceptives to space births and knowledge about childhood illness and treatment and healthier babies will help empower mothers In Pakistan increasing access utilization of healthcare facilities quality of service provision and reducing gap between one Antenatal visit and maximum visits are the major areas that need to be addressed

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