Assess the knowledge and attitude regarding antenatal care among spouses of pregnant women attending antenatal OPD in selected tertiary care hospital Bhubaneswar, Odisha

INTRODUCTION

Pregnancy is that wonderful period in a woman’s life when she spends each and every day in pleasant anticipation, waiting to hold her bundle of joy in her arms at the end of the ninth month. Everything feels rosy and she enjoys every bit of pampering that she gets from her husband, in-laws, and parents. Every woman hopes for a normal pregnancy and normal delivery so that she can cradle and nurse a healthy baby. For that mother has to get proper antenatal care.¹ Maternal mortality is unacceptably high. About 810 women die from pregnancy- or childbirth-related complications around the world every day in 2017. It was estimated that in 2015, roughly 303 000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented.²

Among the several options available in India, creating awareness among husbands appears to be an important prerequisite. The father of today is expected to fulfill the role of providing as well as nurturing, caring and becoming an involved parent. The husband can be a stabilizing influence, a good listener to an expression of doubts and fears, and a source of physical and emotional reassurance.

Objective of the study was to determine the existing level of knowledge on antenatal care among spouses of Pregnant Women and to assess attitude toward antenatal care among spouses of Pregnant Women. To find out the association between knowledge and attitude with selected demographic variable.

METHODS

In this study, a hospital based cross sectional study design was adopted. The target accessible of the study includes the spouses of pregnant woman who attended antenatal clinic at PBMH and who met the criteria that the researcher established for a study. The study was conducted in Antenatal OPD of Pradyumna Bal Memorial Hospital, Bhubaneswar, Odisha, India.

As documented in different literature, the proportion of various heterogeneous (10%-65%) pattern in knowledge and attitude level of spouses of antenatal mother. Therefore a sample size is thought to be maximum by assuming the prevalence of 50%. Therefore by adapting the expected 50% of prevalence at 5% of absolute precision and 95% of desired confidence level, the require sample size is 384. Therefore a total of nearby 400 spouses of pregnant mother will be recruited for the current study. A consecutive sampling technique was adopted to select husbands of 384 pregnant woman.

Inclusion criteria

Spouses of pregnant women who ware gave the consent. Spouses of Primi Gravid mother Spouses of pregnant woman who were attending antenatal clinic selected Hospital. Spouses of pregnant woman who were willing to participate in the study.

Exclusion criteria

Spouses who work as health professionals. Spouses who are suffering with mental disorder.

Data collection tool

The study tool considered of two section Section I was demographic variables consist of baseline information of age, occupation, Socio economic status, educational status of spouses, type of family, family income per month, decision maker, age at marriage, and source of information. Section II was structured knowledge questionnaire regarding selected aspects of Antenatal care. Section III: Likert Scale.

Development of tool

A structural questionnaire was used to assess the knowledge and attitude regarding antenatal care among spouses of pregnant woman. Prior to the study, written permission can be obtained authorities.

Further consent can be taken from samples regarding their willingness to participate in the study. The data will be collected by the investigator herself.

Data collection

Data was collected by the investigator after obtaining permission from the concerned authorities of selected hospital .Prior to the data collection, the spouses ware seated comfortably in a quiet environment.

The investigator was introducing himself, explain the objectives of the study, and obtain consent from the spouses of pregnant woman for maximum cooperation. Each day around 15-20 spouses of pregnant woman was interviewed using the closed-ended structured interview schedule.

Statistical analysis

Data entered in Microsoft excel and analysis was done. The association between pre-test knowledge score of mothers of under-five children and their selected socio-demographic variables was done by chi-square test and effectiveness of planned teaching programme was done by using paired ‘t’ test. The level of significance was set at p-value <0.05.

Ethical clearance and informed consent

The study was carried out after obtaining approval from the institutional Ethical Committee of Kalinga institute of nursing sciences KIIT University Bhubaneswar .The participants were briefed about the purpose of the study and informed consent was obtained prior to the data collection.

RESULTS

Level of knowledge regarding Antenatal care among the spouses of pregnant woman those attending antenatal clinic

The level of knowledge among the subjects of that, the majority of spouses had good knowledge the mean knowledge score was 61.10% taken as the arithmetic average of all the scores.

The standard deviation which is a measure of the variability stood at 17.2 and quite low. (Table no 4.2.2)

The majority of the spouses had adequate knowledge (48.7%) and moderately knowledge (46.6%). Only 4.7% have inadequate knowledge about antenatal care during pregnancy.

Knowledge score with age of spouse. It is found to be significantly different (p=0.002). The spouse having age 20 or below have the significantly lower score than the spouses within age group 21-30 years and 31 - 40 years (p <0.05) (Table 2).

Level of attitude regarding Antenatal care among the spouses of pregnant woman those attending antenatal clinic

Mean attitude score was very high 94.29% with small SD 3.87. Minimum score 78.2% and Max score 100. The attitude of spouse towards antenatal care is found to be extremely high this low variability indicated that the attitude scores of the spouse of pregnant women are closely spread around the average or mean (Table 3).

Association between knowledge and demographic variables

Above data reveals that the knowledge score with age of spouse, it is found to be significantly different (p=0.002). The spouse having age 20 or below have the significantly lower score than the spouses within age group 21-30 years and 30-40 years (p<0.05). Comparison of knowledge score indicated that with the education level of the spouses their knowledge score increases and the difference of mean knowledge score among educational level was found to be significant (p=0.000).

Spouses without any formal education have significantly lower score than all other higher level of education (p<0.05). Knowledge score of spouses with primary education did have significant difference from the spouses with graduate and above.

f: Frequency

The knowledge score did not differ significantly among the spouses with education level of secondary, higher and graduate and above (p>0.05). Association of knowledge score by occupation status of spouses did not differ significantly. p=0.450 It is seen that with the increase in income level of the family, there is significant increase in the knowledge score p=0.000. Association of mean knowledge score with types of family highly significant p=0.018, it means positive relationship between the knowledge score with types of family (Table 4).

f: Frequency

Association of attitude score with demographic variable

Attitude score with age of spouse. It is found to be did not differ significantly (p=0.320). Association of mean attitude score with type of family did not differ significantly p=0.441 association of attitude score indicated that with the education level of the spouses their attitude score increases and the difference of mean attitude score among educational level was found to be not significant (p=0.297). Association of knowledge score by occupation status of spouses did not differ significantly. p=0.902.Association of mean attitude score by income level of did not differ significantly p=0.251 (Table 5).

DISCUSSION

This study was conducted to find out the knowledge and attitude of spouses of pregnant woman regarding antenatal care. Out of 384 cases majority of the spouses (76.8%) were in the age group 21–30 years. The mean knowledge score was 66.10±17.22. The educational status (p<0.000), age (p<0.002), type of family (p<0.018) and average income earned per month (p<0.000) were statistically significant to the level of knowledge.

A similar study conducted by Raymond et al, on husbands of primi gravida attending the ANC at Tertiary and Secondary Health facilities in Ogbomoso. The mean age of respondent was 30.6±5.3 years. The mean knowledge score was 63.55±6.27. The educational status (p<0.001), occupation (p<0.001), type of marriage (p=0.005) and average income earned per month (p<0.002) were statistically related to the level of knowledge.⁷ In this study revealed that, when asked the is the danger sign of pregnancy 61.5% spouses considered bleeding only 38.5% considered constipation, backache, haemorrhoid as a danger sign.

A study was conducted by Iliyasu et al in Northern Nigeria on husbands’ participation in antenatal care among 400 men. When asked to identify situations they would consider as danger signs in pregnancy, more than half (51.9 percent) considered bleeding, about a third considered convulsions (37.8 percent) and loss of consciousness (33.2 percent). Others considered a pale appearance in the mother (21.6 percent) and cessation of foetal movement (15.4 percent) as danger signs. Fever was considered a serious sign by only 4.1 percent of respondents.⁴ This study revealed that 8.6 % of the husbands were not aware of the need of antenatal care. A similar study conducted by Rohini et al in Maharashtra, India, to assess the husband’s involvement in antenatal care revealed that 9 percent of the husbands were not aware of the need of antenatal care.²³

CONCLUSION

The present study assessed the knowledge and attitude among spouses of pregnant antenatal care and found that the spouses had good knowledge related to antenatal care and attitude also positive regarding antenatal care.

ACKNOWLEDGEMENTS

Authors would like to thank their college management for supporting them to do this study. Also to Anindita Mandal, Community Health officer, Jhargram, West Bengal for the inspiring guidance, suggestions and constant encouragement throughout the research study to make this study fruitful and successful learning experience.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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