Determinants Of Antenatal Care Attendance Among Women In The Reproductive Age At Guriel District, Somalia

ABSTRACT

Worldwide it is estimated that 303,000 of maternal deaths occurred in 2015.It is also estimated that in Somalia the maternal mortality rate is 669 deaths per 100,000 live births. Infect one out every 12 women dies due to pregnancy-related issues and one every nine Somali children dies before one year. Antenatal care attendance at four times in Somalia is 24 %. Seventy nine percent of women deliver at home, and twenty-four percent of them delivery with skilled assistance .The major contributors to worsening maternal and neonatal mortality rate in Somalia are low awareness of the importance of antenatal care and inadequacy of subsidized ANC services. Most pregnant women are at greater risk for obstetric fistula due to the three delays. Antenatal care is the most important health intervention to reduce maternal and child mortality and morbidity, through complication readiness and preparing an individual birth plan. The main direct causes of maternal deaths in Africa are: postpartum hemorrhage (27.1%), hypertensive disorders of pregnancy (14.1%), complications of unsafe abortion (7.9%), obstructed labor (9.6%), and sepsis. The main objective of the study was to explore determinants of antenatal care attendance among women of reproductive age in Guriel, Somalia. The specific objectives were to determine the socio-demographic factors, economic factors, accessibility factors and level of awareness influencing ANC attendance. The study used descriptive cross-sectional community-based survey with structured questionnaires. The Study used systematic random sampling, the administered questionnaire was used to collect the primary data from the respondents, Data analyzing of quantitative raw data from questionnaires was coded and entered using SPSS 22.0 data entry program. The statistical mode such as chi-square test was used to test the relationship between the variables, and to test null hypothesis. In the study, estimated mean age was 28 years. The study concluded that most socio-demographic factors influenced ANC attendance. In the study marital status, education level, and parity showed significant statistical association with ANC attendance. The study findings showed that most economic factors played significant role in determining ANC attendance among respondents. The study results revealed that accessibility of health facilities was important to ANC attendance. Distance to health facility, cultural acceptability played significant role on ANC attendance. The study revealed that ANC attendance for the district was low according to the WHO standards and this explains the high maternal and infant mortalities recorded in the district. The research concludes that level of awareness on ANC services was high but unfortunately this did not contribute to increasing the rate of ANC attendance.