CHAPTER -I

INTRODUCTION
Healthy Mothers and children are the real wealth of societies”
(WHO)
Pregnancy is a special, thrilling, and always joyful time to live a woman, which
emphasizes the immensely creative and nurturing capacity of the woman and
bridges it into the future.Pregnant women must be responsible women for
supporting their future child's health.The growing fetus is totally dependent on
the health of your mother for all needs.
Pregnancy is the time of many improvements in physiology and physical.
Pregnancy and childbirth are two main occurrences in a woman‟s life.Women
need special treatment during pregnancy as it provides two health benefits,
first as a community adult member and second as a consequence of her
pregnancy.All human life is born of women on this planet.Motherhood
happiness cannot be conveyed in words.Any culture considers it as a big
event in the family to be pregnant or to deliver a child. Reproduction and
family development are of fundamental importance to most cultures and
indeed to the emotional lives of most people.The backbone of the family is a
woman in her role as mother forms.Childbirth is a biological function that
holds the family continuum.
Pregnancy physiological changes take place progressively but ultimately
affect all body organ systems. Psychological changes take place not only
because of physiological changes but also because of the increased
obligation connected to welcome the family to a new individual who is entirely
dependent on him.
During the first prenatal visit, the routine must be asked, leisure and work-
related exercises are plans for change during the pregnancy.Pregnancy back
pain typically arises in the lumbar region and is increasingly troublesome as
the uterus develops.Low back pain is a common pregnancy complaint and
results in posture changes as the uterus grows.Obesity and previous back
pain issues are also factors of concern.The amount of pain is closely
associated with bendingstrains, lifting, and walking.The use of better body
mechanics when performing these tasks restricts the possibility of serious
injury.
There is an emerging gap in health sectors between developing countries and
industrialized countries. The greatest one is with respect to the health of
women in pregnancy and childbirth. Pregnant women in Africa, South Africa
face a risk of very high maternal mortality which may be up to 200 times more
than that of women living in industrialized countries. Due to early marriage,
early pregnancy, and lack of health awareness the woman is at risk in
developing countries.206
Worldwide every minute, 1 woman dies with complications related to
pregnancy, almost 6,00,000 women die annually, 99 percent of deaths in
developed countries these occur. In India, every 5 minutes, 1 woman dies
from pregnancy and childbirth complications.A total of 121,000 women are
represented each year. Every pregnancy faces risk and 15 percent of women
develop problems that endanger their life whereas, 65% of deliveries are
carried out at home. Only 41% of women have trained workers who endorse
childbirth.207
Mother plays an important role in the family. Hence maternal death has very
serious consequences within the family. The death of a mother increases the
risk to the survival of her young children.
The road to maternal and infant death Is a long one. But it is possible to
escape the tragedy of its end at various points along the route. The challenge
is to ensure that every woman has the chance of safe motherhood.
The World Health Organization trailed a system of four routine antenatal visits
for women assessed as being a low risk (Villar et al 2001). They found no
statistically significant differences between the outcomes of pre-eclampsia,
severe anemia, urinary tract infection, and low birth-weight infants between
the intervention group and standard care, in the 24, 678 women enrolled in
the study.
Patterns of visiting continue to be investigated and Dowswell et al (2010)
compared standard care with reduced visiting schedules investigated in seven
randomized controlled trials. They concluded that for high-income countries
there was no difference between the groups but for low to medium-income
countries, perinatal mortality has been increased in those receiving decreased
visits and the authors conclude the visits must not have decreased without
close control of the impact on neonatal outcome.
Antenatal care is the medical supervision of women during pregnancy, from
the time of conception until labor. During the antenatal period, maternal as
well as fetal monitoring is done on a regular basis. Premature diagnosis may
avoid maternal illness, injury, foetal death, maternal mortality, child mortality,
and morbidity during pregnancy.
The main aim of antenatal care is to promote maternal health and help in
normal fetal development. The antenatal care‟s main objectives are as
following:
 Review foetus and mother health status.
 Promote and maintain the mother‟s health status during the antenatal period.
 Orient mother with the physiology of pregnancy and labor.
 High-risk pregnancy screening; and prevent and treat any untoward
complications.
 Remove anxiety and fear associated with pregnancy.
 Reduce maternal and infant morbidity and mortality.
 Discuss with the couple about the need for family planning.
For a normal pregnancy, generally, 5 check-ups are advised at the 10th week,
18th week, 24th week, 30th, and 36th week.
During pregnancy, a mother is given counseling and advice regarding various
things that help her in carrying her pregnancy well. Counseling during the
antenatal period is essential, especially for the mother who has got pregnant
for the first time, some of the points which are discussed as are helpful during
counseling are:
 Strengthening prenatal bonding: When counseling is provided to a couple
during the antenatal period, it helps in enhancing the bond between the fetus
and the parents. Various developmental aspects of the fetus during the
different periods of pregnancy are explained to the parents. It makes the
parents feel closer to the baby in the womb.
 Overcome anticipatory fears of labor, birth, and parenting: During pregnancy
mother has a fear of the period of her labor. The primigravida mother has
heard many things about the experience of labor from her near and dear
ones. Sometimes it can make her unnecessary nervous. During counseling, a
counselor can try to alleviate the mother‟s fears. Mother can discuss all her
doubts openly. Parenting brings with itself plenty of responsibilities.
Sometimes a couple can become anxious about certain issues related to
parenthood. Giving antenatal counseling can alleviate all types of anticipatory
fears.
 Reduce stress that can negatively impact labor and birth: Stress of strain
during the pregnancy, whether it is physical or psychological, affects the
pregnancy. During the visit for counseling session, it is taken care of by the
counselor that the mother should not face any stress, especially
psychological. A mother, who is free from mental tension, can give birth to a
healthy baby in a healthy way.
 Find one‟s own individual style for coping with labor pain and closing the
birthing facility: Every individual is different, certain pain relief measure work
for some people, while the same measures may not work for another group of
people. After knowing the mother, a counselor can advise for a method of
comfort and pain relief that can work best for her. A couple can also make a
choice for a good birthing facility after taking with counselor other advice,
which is given to a mother during the antenatal period are with the uterus
growing in size, the center of gravity of the body changes and enter to
compensate for the change in center of gravity, the posture, and style of
walking changes. This can cause back pain or other injuries:
 Paying proper attention to personal hygiene, such as bathing, maintaining
dental hygiene.
 Having adequate rest and sleep in a comfortable position.
 Wearing loose and comfortable clothing and avoiding high heel shoes
 Traveling must be avoided during the first and last trimester, as the jerks
can disturb the pregnancy.
 Even the coitus should be avoided during the first and third trimester.
 Specific attention should be given to diet and smoking and alcohol should
be restrained.
 Mother has to get immunized for tetanus or rubella.
Keeping fit and healthy during pregnancy is important for the well-being of the
mother and that of the baby. It also means that the body of the mother may be
more prepared for the physical demands of labor, birth, and puerperium.
Exercise during the prenatal period can help to reduce post-birth recovery as
well as decrease labor time and associated complications. Exercise will
improve muscle tone and control and reduce pregnancy-associated aches
and pains.
The benefits of exercise are:
 Pregnancy pain and aches reduction, for example, back pain, cramps.
 Reduced constipation by accelerating movement in the intestine.
 Enhanced body awareness and posture.
 Aids post-natal recovery,
 Reduction in the minor ailments of pregnancy like tension, stiffness,insomnia
as well as constipation.
 It helps to enhance the capability of women to deal with labor pain as well as
childbirth.
 Physical exercise enhances the skin‟s blood flow which provides a healthy
glow to the skin.
 Help to better sleep by relieving tension and anxiety that could restless the
mother throughout the night.
 Mother may receive emotional lift through the releasing of internal hormones
such as endorphins.
 It will raise the level of energy and make the mother well-prepared for the
work of labor.
 Mother would be happier as the release of tranquillising hormones after
exercise helps to relax.
 After delivery, the mother will more rapidly regain the shape.
Changes in the pregnancy, affecting the pregnancy:
 The respiratory rate is increased in pregnancy, because of which the body
has to work harder to provide oxygen to the baby. This can make the mother
breathless during exercise.
 As the gravid uterus becomes enlarged, the lower back becomes more
curved. This causes a shift in the center of gravity, which can make the
mother more likely to fall so she has to be careful during the pregnancy.
 The joints during the pregnancy get loosen by the release of the hormone
called relaxing. This hormone makes the joints relax and there are increased
chances of sprains. So, the mother needs to warm up and cool down
thoroughly.
 As the blood volume has increased during pregnancy, it can cause
lightheadedness. So, the mother should be careful while rising quickly.
Posture during pregnancy:
 Standing properly: Stand on both feet with a balance between the heels and
the toes that are equally balanced. She will force one foot forward and put her
weight on that foot for a few minutes if she has to stand at one position for a
long time. After this with the other foot do the same.
 Sit properly: Sit should back in the chair with your thighs and back
supported, your legs slightly apart, feet flat on the floor. Use leg muscles to
lowering and raising yourself. Never sit on the chair‟s edge.
 Picking up things from the floor: Come near to the item. Squat down, bend
the knees, and also keep your back straight. Holding the item against the
body, bend your elbows. Use the muscles in your legs, slowly and smoothly
straighten up and stand. Knees and hips bend, but not back.
Mother is made to kneel on all fours. She must keep her spine at the same
level. She should gently pull in the lower part of the abdomen below the
umbilicus and keep the spine straight. She should breathe normally and
maintain this position for the count of 10 and then, relax. In pelvic rocking
exercise mother is the semi-sitting position with the proper support with the
pillows by keeping the feet flat on the floor, knees are flexed. Mother can
place one hand under the small of the back and the other hand on the
abdomen. She is advised to tighten the muscles of the abdomen and
buttocks, and pressure is put on the land placed under the small of the back.
She should breathe normally and maintain their position for the count of 10
and then, relax.
In pelvic floor exercise: The muscles of the pelvic floor are stained a lot in
pregnancy and labor. The exercise of these muscles helps in maintaining the
tone of the muscles and regaining their earlier strength quickly after the
pregnancy. The main exercise performed here is the kegel exercise this
exercise can be performed anywhere, such as sitting at one‟s desk or
standing in line at the store. In this, the muscles of the back passage are
squeezed, so as to prevent the bowel action. In the same manner, Muscles
are squeezed so as to prevent urine flow. These muscles are drawn inside
and this position is maintained for the count of 10, then relax. It can be
repeated up to 10 times.
Circulatory exercise: As we know that venous return during the pregnancy is
less. So, it can lead to varicose veins, oedema, etc. to prevent such
complications, following exercise may be advised, especially before getting up
from resting. Foot and leg exercise is the semi-sitting position and the legs are
to be supported. Bending and stretching of ankles is done. After this, a mother
is told to circle both feet in the clockwise and anticlockwise direction. This
exercise can be repeated often.
Breathing exercise: It helps the mother to deal with labour pain by knowing
how to breathe deeply and strengthens her abdomen. Mother is made to lie in
a semi-sitting position with bending knees as well as feet flat on the floor.
Slowly breathe in and contract abdominal muscles. To relax the muscles,
breathe out deeply and slowly. For few times breathe normally, and again
repeat just 2 to 3 times the deep breathing.
Points to be taken care of during exercise:
 At each workout session warm-up and cool down.
 When women feel dizzy or faint, should stop or slow down the workout.
 Get plenty of liquids to drink.
 Keep a posture good.
 Don't overheat your body. The body's overheating was attributed to certain
birth defects.
 A comfortable and well-fitting bra should be worn.
 Stop exercising on the back from the middle of your pregnancy, because it
puts too much pressure on the main veins and decreases the supply of
oxygen to your placenta and baby.
Warning signs, to stop exercise:
If any of these symptoms occur, stop the workout and call your doctor: Feeling
dizzy or weak, vaginal bleeding, pain in the chest, Increased breathing deficit,
muscle weakness, headache, uterine contractions, leaking of fluid from the
vagina, fetal activity decreased.
A portion of good food makes and optimum maternal nutrition is essential for
a pregnant woman. As the majority of physical as well as mental development
of the child is taking place during the first three months of pregnancy, so this
is the crucial period of pregnancy. For a healthy and successful pregnancy,
the role of nutrition is significant. The most demanding time of a woman‟s
pregnancy, and so it is even more essential to eat a healthy diet.
Carbohydrates produce energy for the body. The intake of carbohydrates
should be sufficient, otherwise, the weight gain in pregnancy is poor.
Foodstuffs such as rice, wheat, potatoes, sugar, fruits, etc are rich sources of
carbohydrates. Diet must contain essential fatty acids. Butter, Ghee,
Vegetable oil, milk, meat, and egg contain fat. A mother must consume a
variety of high-protein foods because while pregnancy the requirement
increased. For the appropriate utilization of protein, vitamin B6 is required. All
proteins are available from meat, fish, nutrients, beans, peas, and dairy
products like milk and eggs. During your pregnancy, the following should be
taken: phosphorus, calcium, iron, sodium, iodine, zinc, and iron. The mineral
deficiency leads to pregnancy complications and negative effects on the fetus.
Iron helps build bones and teeth and is responsible for haemoglobin
production. Iron deficiency can be caused by anaemia. In this case, iron
supplements have to be taken once or twice a day. More iron-rich foods such
as raisins, potatoes, broccoli, date, broccoli, wholegrain bread, green leafy
vegetables, and iron-fortified cereals may help to avoid anaemia.
Calcium is needed, doubled its normal requirement, during the pregnancy.
The teeth and bones of a baby need to grow healthily. This begins to develop
at around the eighth week. The rich calcium sources include egg, milk, green
vegetables as well as cheese. The acceptable dietary calcium amount is
dramatically increased from 800 to 1200mg while pregnancy and breast-
feeding.
One of the key nutrients required during pregnancy is folic acid. This is
required particularly during the initial few weeks in order to develop the
nervous system of a baby. It enables the prevention of neural tube defects
and other birth defects such as congenital heart disorder, cleft lip. Its
supplements can be taken during pregnancy. Folic acid is found in beans,
green vegetables, yeast, liver, fortified cereals, and bread. During cooking,
folic acid is quickly lost; so green vegetables should be boiled or steamed.
Due to the mother's nutrition via the placenta, the foetus grows and develops.
As the nutrients are delivered to the fetus through the placenta, the fetus can
also be given any toxins in the mother's system. These toxins also damage
the foetal organs, which are delicate. Substance abuse means the use of
alcohol, tobacco, and many other drugs, which are considered unsafe during
pregnancy, not only for the mother but for the baby as well. Substance abuse
in pregnancy deprives the baby of all the nutrients and oxygen that they need
to develop normally.
The products, such as, cigarettes, alcoholic beverages, or even illegal drugs
can affect the woman who uses it, and even crosses the placenta and enter
the foetus, where it can also create a serious problem for the foetus.
Childbirth is a unique and special experience for the mother as well as father.
Both are experiencing a change in their lives with the coming of new life
amongst them. Though the women‟s body is itself designed to give birth,
providing education for childbirth had always been there. Mothers and
mothers-in-law are always there to provide their teachings and experience to
future generations. For a woman, education for childbirth is essential as:
 Most of the women do not have much of the needed knowledge regarding
birth. They also lack a positive experience with birth.
 Sometimes the women‟s own emotional issues interfere with her ability to
birth freely.
 Nowadays in nuclear families, when a woman cannot receive much of the
knowledge from her elders or any other, she depends on the media for much
of the guidance. Most of the time her idea and vision of birth are distorted by
the media.
 During these crucial periods, sometimes the couple has to make some very
important decisions, which they cannot make if they don‟t have the proper
knowledge.
The things which are to be taught for happy childbirth may include:
 Telling about mother about the anatomy of her reproductive organs and how
the changes occur in the physiology of these organs during and after
pregnancy.
 Relaxing techniques can be told as this is the period of great stress and the
mother feels discomfort during this period. Proactive prevention of problems in
pregnancy has to be told.
 Methods of reducing the pain of labour are told to the mother.
 Careful attention to the emotional aspects of pregnancy, birth, and
parenthood has to be paid.
 Stages of labour and birth are also told so that the mother gets
psychologically prepared for that period.
 Knowledge is provided regarding various medicines, which can be given to
the mother for various reasons such as pain relief, easy delivery, cervical
dilation, induction of uterine contraction, etc.
 Mothers should also be taught about any complications, which can arise due
to any medication or operative delivery.
 Some women themselves chose to have a caesarean section and for some,
the present complications in pregnancy arise the need of performing
caesarean section. So, information has to be provided related to the
caesarean delivery also.
 The period after the delivery of the baby is the puerperal period. Mother has
to be taught regarding the change which she has to face during this period
and how she should maintain her health.
 New-born care is an essential part for which many mothers are anxious
about the needs of the babies are to be explained to the new mother so that
she can provide health care to her new-born.
 Early and scrupulous attention to nutrition and exercise is given. The
nutrition of the baby is maintained by proper breastfeeding. Knowledge has to
be given to the mother to eat healthy so that she can give healthy nutrition to
the baby via breastfeeding. The position of the feeding is also important.
 Childbirth education helps the parents to prepare for childbirth as well as
parenthood. If the education is provided to the couple properly during the
antenatal period, it helps to provide valuable knowledge on such matters like
made a decision about and during labour, pain relief, labour skills, child and
postnatal care, parental and breastfeeding skills.
There is a major role of the husband and the family in the life of a mother
during her antenatal, intranatal and postnatal period. Mother having the
support of husband and families, give a healthy birth, and suffer from fewer
complications as they get timely support. The involvement of men is
necessary as men are key decision-makers of the family. If there is the
involvement of the father, it will result in increased support for women during
the pregnancy. Men become more committed to the use of contraceptives.
Fathers act as a better role model for children. Reduced violence at home.
There are better communication and stronger bonding between partners and
the family.
As the husband gets to know about his wife‟s pregnancy for the first time, he
has mixed feelings of joy, apprehension, happiness, and anxiety. He becomes
more responsible as there is going to be an addition in his role of husband to
the role of the father. She becomes more supportive of the wife. During this
period, he gives more attention to the needs of his wife, providing timely
check-ups, healthy and adequate nutrition for the expecting mother.
The weak condition of the mother along with the minor ailments, which she is
experiencing at this time, may bother the husband. Quitting smoking is one of
the major decisions, which has to be taken by the father at this time. Passive
smoking by the mother at this time also can have deleterious effects on the
mother's as well as the baby‟s health.
NICE also produces quality standards, in addition to full national clinical
recommendations, which are a succinct collection of statements aimed at
promoting priority changes in quality in a specific field of treatment and
evaluating them and the antenatal Quality Standard comprises 12 state
frameworks for examining maternity services and provide benchmarks for
audit and commissioning purposes, although most of them relate to women
with risk factors.
During the 1970‟s safe motherhood initiative groups sought the attention of
government and people worldwide for urgent measures to ensure safe
motherhood. Following this decade, during 1987 in Nairobi, the International
Safe motherhood conference was held with emphasis on the maternal
component in maternal and child health programsand for the first time, it drew
worldwide attention in relation to the cause, the magnitude, and
consequences of maternal morbidity and mortality. Immediately thereafter
safe motherhood launched globally with the help of WHO, UNICEF,
Populationcouncil, International Planned Parenthood Federation, and World
Bank. In this context,the creation of a national safe motherhood program was
urged. As an outcome of this conference, the national child survival and safe
motherhood program came into existence in India in 1992, with active support
from international agencies like World Bank and UNICEF.
The World Health Organization estimates that globally 150 million
pregnancies occur annually. India being the second populated country in the
world contributes to 20% of global birth. Approximately 20 to 25 million
women in India experience pregnancy annually. In the year 1901 antenatal
care had its beginning, which Ballantyne first published his, a plea for a pro-
maternity hospital since antenatal care is now an accepted part of maternity
health services and has proved to be a great step for a word in lowering
maternal and prenatal morbidity and mortality. Childbirth is a biological
function that gives joy to the mother and the family. This turns into a tragedy
when a woman loses her life while performing this social obligation. In all
societies, the family is the central nucleus for people for their lives, their
dreams, and their health. The foundation of the family is a female in her role
as a mother form.
India is observed to have the highest incidence of maternal mortality of 5/1000
live births and a mortality rate of 68/1000 live births in an infant. In India, the
main causes of maternal death were hemorrhage, sepsis, anemia, and
toxemia. The incidence of maternal mortality is observed between the age
group of 15-24 years (95.6%). Nearly 50% of deaths among young women in
the reproductive age group could be avoided by timely identification and
treatment or early referral and over 75% of deaths among young children can
be eliminated by the proper implementation of prevention and promotion of
health programs
Majhi, et al (2001) conducted a retrospective analysis on all maternal death at
R.G. Kar medical college and hospital at Calcutta. The overall maternal
mortality rate was 686.67/1000 live births, the direct causes were toxemia in
pregnancy (53.20%), hemorrhage 16.5%, sepsis 12.31%, severe anemia
6.4%. Maternal mortality was high among rural (59.6%) and from low socio-
economic status (59.6%). The study brought out the importance of the
underlying factors responsible for maternal mortality were low socio-economic
status and illiteracy.
To improve pregnancy outcomes, education, motivation, and mobilization of
pregnant women, families, and communities regarding safe motherhood
should be provided.
The research studies reports created an insight that there is more prevalence
of complications related to pregnancy, childbirth among the mothers.
Therefore, the investigator felt that it was necessary to assess the efficiency
of a planned teaching program regarding safe motherhood. This study aimed
to help in ensuring safe motherhood by throwing light on the prevention of
complications during pregnancy, delivery, and post-natal period.
The study was conducted in Tamil Nadu about knowledge and awareness
about antenatal care the study shows that among 260 the 180 (pregnant)
women had the knowledge and awareness about antenatal care. So, it shows
that there should be a realization of the importance of antenatal care by
pregnant women.
In 2000 importanst study explain the and “judge the knowledge, attitude, and
practice regarding care during pregnancy, delivery and post-natal period
among women in Italy”. About 9004 women were interviewed, 23% had
attended antenatal classes. Women who attended antennal classes were able
to apply the knowledge to reduce the threat of being disappointed with the
childbirth experience. The study showed this is because pregnant women
received adequate knowledge regarding antenatal care as they attended
antenatal classes.
In 2009, Blended and Marshall B. conducted the study under the title “To
assess the poor antenatal care and pregnancy out came in French districts”.
The study found a total of 848 poor attainders and 759 good attainders at the
antenatal clinic. In poor attainders, it was found that the group had high rates
of pre-term labor low birth weight as well as still-birth due to pregnancy-
related complications. The conclusion of the study was the lack of health care
during pregnancy outcomes among women's access to health services. The
present study directly supports the need and importance of antenatal care to
reduce the adverse pregnancy outcome in the relation of mother and child.
56
Motherhood is said to render a woman perfect with Narayan, U. . (2010)
Mother Nature gets ready each woman to conceive, deliver and raise a child.
Definition of Pregnancy for Human Beings is a time at which a female bears a
living organism in her womb from creation to childbirth. Those nine months
give parents-to-be a chance to understand, adjust and plan for parenthood,
the arrival of a child in the family is a special occasion with long-lasting
relevance. The main objective of successful pregnancy is a healthy mother
and child. It should be a positive experience of parent-to-be growth. Pre-Natal
care makes sure the birth of a healthy child and doctor visits. Nutrition and
mother's health ensure a healthy developing foetus and also an
uncomplicated birth. Although pregnancy progresses, the body will gain
weight and change shape. Exercises and Comforts help with daily exercises
in the maintenance of postures and movements. Labour and Birth is the
climax of pregnancy childbearing is a miracle during which a woman is
honoured to perform with help of Mother Nature. Abnormalities and
aberrations that appear in this normal cycle, so one needs to hope that there
will be no complications during childbirth. Knowledge and antenatal treatment
would help put forward a safe, happy child in this wonderful universe and
allow the parents happily look forward to the challenge of caring for him / her.
Islam, M. M., and Masud, M. S.33 (2018).Most pregnancy is considered to
pose such a risk of complications and adverse health effects- almost all take
less risk, while others take more risk. Complications during labour,
miscarriage and perinatal pregnancy are the primary causes of illness and
mortality. As per statistical report of United Nations (UN) Maternal Mortality
Prediction Inter-Agency Community, about 830 people die every day
worldwide due to maternity or childbearing complications in 2015; an
unprecedented 99% of such deaths arise in developed nations. Although, on
the other hand, around 2.6 million deliveries ended as early births in
developed countries in 2015. In fact, deaths and injuries related to pregnancy
are not predictable; many of it could prevent by easy and not so expensive
prenatal care in pregnancy, childbirth along with in postnatal
periods.Particularly within the context of maternal treatment, Antenatal
Treatment (ANC) offers the foundation for comprehensive preventive care
programs, inclusive of education regarding health, prevention and screening
of diseases. Several empirical findings have shown that ANC is the only
facility capable of minimizing maternal mortality up to twenty percent,
providing higher efficiency along with proper monitoring of antenatal
attendance.
The aim of ANC is for protecting and monitoring the well-being of the foetus
and the mother, to detect certain complications and take the necessary steps,
to respond to the issues of the mother, to start preparing the mom for birth
and endorse the healthy behaviour of the mothers. ANC programs are often
structured to improve patient outcomes; decreased maternal and neonatal
deaths, reduced postpartum anaemia, and sufficient birth weight. For ANC
services, a health care specialist who alerts people to the signs and effects of
risk and takes immediate action to identify issues.
Routine antenatal services and visits, as they are currently practiced around
the world, originate from models built around a century ago in Europe.
According to the ecu system model, women visit clinics or health care
practitioners on a monthly basis during the first six months of pregnancy and
once every two to three weeks for the next two months, but every week till
delivery. So, at the time of her conception, a lady will have around 12 trips.
Usage and scheduling of daily prenatal care visits is subjective and without
proof of cost-effectiveness in the older European method model. Although
newer research and technologies concerned, the effectiveness of specific
components in antenatal care systems has been tested several times of terms
in streamlining material, continuity of pace and implementation of antenatal
care interventions and systemic evaluations.
Based on the ground-breaking cluster randomization the WHOACT: World
Health Organizations Antenatal Care Trial throughout 2001 with proper
reassessment of the efficacy of various models of maternal health care
solutions, WHO proposed a cost-effective, evidence-based plan that would
provide at least four pregnant mothers without difficult pregnancy. WHOACT
stated that the discount on the many of visits to atleast 4ANC visits weren‟t
lower than the traditional Western ANC packages, with potential adverse
outcomes for women and new born, or could lower the cost. By economically
LMICs (Low-and Middle-Income Countries) rate of usage of antenatal care
facilities increased after the launch of the WHO ANC model in 2002 which
was seen as an emphasis on antenatal care or specific antenatal care, it
became a scientifically focused method to providing evidence-based
interventions in 4 essential circumstances during pregnancy.
Therefore, in the light of the 2010 Cochrane declaration, that indicated that
reduced antenatal care visits were generally provided for safety, the
WHOACT knowledge data was again reviewed by the global research
community. It was reported that there was a higher likelihood of foetal loss for
women having far less prenatal visits, particularly for high-potential female,
with the danger of foetal loss amongst 32 and 36 weeks 80 per cent higher,
whereas for low-potential women it would be 50 per cent higher.
Based on these feedbacks, the Planet Health Organization has followed up a
recommendation during 2016 to enhance the quality of antenatal care and
decrease the risk of stillbirths and pregnancy complications, as well as to
provide women with a positive perception of pregnancy.
Suggested frameworks spanning five different levels of routine prenatal
nutrition, maternal and foetal screening, and preventive strategies, as well as
planning for the treatment of numerous physiological symptoms during
pregnancy and health systems to enhance the use and quality of antenatal
care. The 2016 WHO ANC supervision raises the amount of experiences that
a pregnant woman with health care during breastfeeding from an average of
four to a minimum of 8 contacts: one touch before the trimester, two
experiences during the trimester and five contacts during the trimester. In
order to provide effective precautions for visits, both quality and content of the
ANC must be monitor.
Mostly to one‟s knowledge, there does not exist any research in Bangladesh
that seeks to address such issues that influence treatment and content of the
proposed antenna visits by the World Health Organization. The present study
is an effort to make a contribution to this.
According to Kifle, M. M.,37 et al. (22 October 2018) Since the last twenty-
five years, the MMR globally is decreased with almost 44% from
approximately 385-maternal fatalities for every 10000 births in the year 1990,
and now 216 as reported in 2015. However, such recession is especially
unequal, for countries with low-incomes experiencing greater effects. By
2015, these countries accounts for almost 99% deaths worldwide, with SSA
for about 66 per cent of the death toll. The predominantly important in the
SSA area (Sub-Saharan Africa), whereas a higher fertility level, higher danger
maternal mortality, inadequate health services, low behaviour for seeking
health and malnutrition has contributed to years of stagnation in maternal
mortality. Often the deaths are because of common obstetric factors like
sepsis, haemorrhage, and improper abortion. Such risks arise during the time
of childbirth and are challenging to foresee, but can be efficiently controlled
and death avoided by having health facilities fitted with trained birth
attendants in a safe setting.
Professional birth attendants and health workers will provide either reception
centres or medical care, so the next most promising option for low-income
countries such as Eritrea is introducing them to health services by robust
transfer network.
WHO indicates to delivery and care provided by qualified attendance or a
medical professional that has recognize as well as managed normal delivery
and work, who can recognize and treat antenatal and prenatal issues or give
basic care or other such services? Conversely, the proportion of SBA
deliveries was below the recommended dose. Approximately half of all births
in sub-Saharan Africa are assisted by SBAs. A significant proportion of births
take place at home, including in countries where antenatal treatment (ANC) is
widespread.
Selection of the place of delivery has been continuously identified as being
correlated with neonatal and maternal effect. Delivering in a good and proper
facilities operated with trained birth attendants is related by minor maternal
morbidity and mortality rates than at home. Health care also plays a crucial
role in minimizing stillbirth and rising the wellbeing of new-borns. In view of
the claimed wellbeing profit of antenatal care, it is essential to know the sort of
issues related to the choice of place of delivery.
Analyses of the usage of health facilities also found that a variety of threats
have an effect on a woman's practice of seeking treatment. Demographic
factors that are revealed to enhance the probability of use of health facilities
include, marital status, young age, high autonomy degrees, low parity,
employment, utilize of new contraceptive strategies, utilize of prior health
facilities, use of antenatal care, prior the past of obstacles, considered high
eminence of caca Socioeconomic variables tend to be more important. The
most critical determinant of the utilization of reproductive health facilities is the
quality of schooling of women.
Prenatal care storage expenses, medications, and travel time opportunity
costs have often been seen as a disincentive to service utilize.
Socioeconomic measures like urban living, living conditions at home,
household income and occupational status has shown clear forecasts of a
woman's approach to the utilize of reproductive health services. Apart from
demographic and socio-economic influences, the personal climate, including
cultural values and expectations of good behaviour, has a significant effect on
the usage of health facilities. Research has also publicized to each
demographic and socio-economic influences of health care of the
reproductive system is influenced from community-based impacts on health-
that seeks activity affecting how consumers perceive their own wellbeing and
accessible health resources. Such cultural values and expectations are
reflected in an individual's choices about health, since they are partial through
what someone think the society sees his or her actions.
Even so, females take decisions on distribution in a group and regional sense.
Knowledge on the relationship between regional systemic factors and
consumer delivery choices is less visible.
In addition, several empiric studies indicate that, for LMIN, macro-social
variables such as population density physicians, higher demand,
industrialization and urbanization, and lower wealth inequalities influence the
use of delivery services and could more successful in plummeting maternal
mortality than initiatives directed at individuals. Severe lack of health facilities,
insufficient numbers of contributors of health care, bad care-receiving
behaviour, intensely old practices of culture such as mutilation of female
genitals, home violent behaviour, early wedding and abortion, low levels of
learning, low contraception and customary gender roles all hinder the
empowerment and decision-making rights of women that have prevailed.
Mortality rates of mother to be higher for every 100,000 live births, equal to
998, amongst the biggest number for Africa. Number of females in the clinic
were much lower, mostly because of the long distance between health-care
facilities currently narrowly distributed and also due to transportation cost. In
order to overcome as obstacles, several people tended to receive childbirth
care from conventional birth attendants that were centrally accessible and
delivered facilities free of charge, excluding at risk because of hazardous
birthing procedures practiced by them and not-able to control much of the
normally associated problems which arose in the delivery. Mortality is a
purpose of women's resources.
Depending on the WHO, the antenatal care is included of 3 components:
health measurement, past use, physical assessment and laboratory findings,
health promotion and maintenance advice on diet and nutrition, birth control,
pregnancy-related information, additional contraception and breast-feeding,
and antenatal care services consisting of: although variations in diet and
nutrition.
A large percentage of mothers did not undergo at least 4 treatments in a
variety of developing nations, and conformity with the minimum volume of
recommended material seems not to have been reached due to very poor
quality, willingness to pay the price for care, cultural differences and lack of
data. Bangladesh, a developing country in South East Asia, is no exception to
this. The Ministry of Health and Family Welfare (MoHFW) Bangladesh is
tracking the WHO suggested visits to ANC and hence the key substance of
the visits to the ANC. A very large number of studies in Bangladesh looked at
factors related to prenatal care visits and delivery care. Therefore, both of
these study findings concentrated primarily on the objective analysis of ANC
visits, obscuring the scope and efficiency of antenatal visits.
The standard and efficiency of health services can be poor, while the number
of antenatal appointments for patients may be very high. Prior findings have
found that, adding to number of visits to ANC, and the issues discussed have
a substantial effect on the performance of ANC programs. It has also been
noted that poor performance of ANCs has an impact on the use of ANC
services.
Because the general reproductive wellbeing of an individual is ultimately
defined by the total coverage and quality of antenatal care visits, it is therefore
significant to look at the volume, patterns and determinants of coverage and
quality of antenatal care services in order to measure the level of ANC
facilities. Many stakeholders should take appropriate action to develop
maternal health and postnatal treatment. There are several studies that
specialize in both suggested regular ANC visits and subject of ANC visits to
developing countries.
The objective was to ensure compliance with the recommended amount of at
least eight prenatal care visits and therefore the level of compliance by
suggested content of the prenatal care visit in Bangladesh. Attempts were
also made to remove variables impacting the usage of prenatal care visits and
hence prenatal care visit content in Bangladesh.
After independence, the Government of Eritrea has worked tirelessly during
the Ministry of Health to promote the provision of quality health services and
to increase the availability of these services in a fair and affordable manner.
However, for a very short time after independence, Eritrea tried to move into a
boundary conflict with Ethiopia, as the subsequent war had a significant
impact on the economy, disrupted demographic trends and affected global
health-related policy challenges. With a population of around 4 million, Eritrea
currently has a lower per capita income. The overall birth rate (average 4.5
children per woman) is high, with only 19.6 per cent of girls satisfied with
modern methods of birth control. Although the use of ANC is comparatively
high in Eritrea, the use of childbirth health facilities remains low.
Over the course of 2015, the clause of atleast one ANC contributed to higher
than 95% and 80% for the women in urban areas visiting four times, and
although 47% only for the rural women with 4 or more visits. More important is
the fact that there exist large differences in the proportion of births in health
services between urban and rural regions.
For case, the “Eritrean Population and Health Survey” (EPHS) released last
month showed that just 17 per cent of women of rural areas delivery in proper
facilities comparison with 63 per cent in many other cities and 93 per cent of
mothers residing in the city. A most popular explanations or barriers for not
having a distribution service have been the acquisition of care capital, 39 per
cent of the community decided to travel 35 per cent to go to the center, 33 per
cent of the people replied that they did not intend to go on their own, to 20 per
cent described the support line as providing clear links to medical treatment.
Approximately 12 % of respondents said that low quality of care was also a
hurdle. Several women recognized that they didn't know how to get there, and
11 percent said that getting their husband's permission was one of the
barriers to giving birth. Despite of the number of live babies, marital status or
job status, each people surveyed have defined access to medical services as
the greatest barrier to access to health care. The majority of women in the
young 15-19 of age group, rural regions without employment, and lowest
second or lowest income quintiles listed the need for transport and expanse
as the most important barriers to health care. Even so, Eritrea has prepared
significant growth in plummeting maternal mortality in the 25 years. Lately,
according to 2017 “National Lot Quality Assurance Study” (LQAS), almost 95
per cent of women have expected ANC and 63 per cent of babies have been
seen in health facilities. There was a 68.5 per cent decrease in maternal
mortality between 1990 and 2015, with an overall annual drop of 4.6 per cent.
As per the 2 “Health Sector Strategic Development Plan” (HSSDP), such
changes are expected to carryon increase the political will, commitment and
investment of the health sector over coming five years. Such development
was primarily due to the emphasis on some functioning aspects of imperative
programs of maternal health (proper ANCs, availability of health facilities,
emergency diagnosis of obstetric condition, postpartum care and family
planning) and comprehensive urban areas with high density. In fact, an
efficiency of prevention approaches based on the community has shown.
Turan et al, for example. Low-cost, communities lie on intervention in Eritrea
has been shown to be associated not only with a substantial increase in
conscioobstetric care systems inusness of safe motherhood, but also with
expanded utilize of essential maternal services, with the availability of health
facilities. Traditionally, in most of Eritrea 's cultures, the overweight family is
seen as a sign of higher rank, security and preservation of relations.
By identifying the purpose of childbearing in Eritrean cultures, a number of
studies have shown that day-to-day childcare and childbearing practices
source of profound fulfilment for Eritrean women. The majority of rural
societies still operate as networks of interconnected and reliant classes,
emphasize the family or association rather than the individual. Thus, people
residing in Eritrea rural areas were less inclined to build being sexual
decisions outside of the cultures, social networks or environments in which
they live. In small, sexual impulses are issues that affect young people
suffering from a variety of societal stress, including society, faith and well-
being. The goal of this analysis to recognize the number of issues relevant to
the choice of girls for distribution in selected rural communities in Eritrea.
Singh, A., et.at.79 (2014)Antenatal Care (ANC) therapies, such as antenatal
drugs, IFA vitamins, tetanus toxoid (TT) injections, more diagnostic tests,
opinion and counselling, has suggested for a long time and has identified by
several countries around the world. Usually, antenatal care services are
important to improving parental and child outcomes (Hollowell et al. 2011;
Wehby et al. 2009). World Health Organization, in 2006 suggests that every
pregnant woman must have a minimum of four prenatal appointments, ideally
first prenatal examination in first trimester. Reproductive Health
Recommendations state, in India, between other aspects, that a woman
pregnant with a child should visit 3 time and her first appointment would
ideally be in the first section. Instruction also recommend that each pregnant
woman should eat ninety or more than that tablets (IFA) and must undergo
minimum 2 TT injections (MHD 2005). ANC are given without any cost to
public health organizations including Primary Health Centres and Sub-Safety
Centres. Females can be provided to such facilities through private supplier.
Even if ANC initiatives have been part of policy and service policy since last
30 years, numerous ANC initiatives are not subject to a comprehensive as
well as a thorough assessment of efficacy in decrease neonatal mortality
(Bergsjoand Villar1997).
Research findings on effect of antenatal patient care on child and maternal
health outcomes presented uncertain proof. A current year's systematic
analysis of high-income or economically and environmentally developing
nations found inadequate confirmation of acceptable consistency to support
the introduction of either the ANC measure for minimizing child or neonatal
mortality in distressed or drawback women (Hollowell et al. 2011).Research
conducted by Carroli et al.(2001) revealed low consistent proof of efficacy,
duration and frequency of access to conventional ANC facilities for maternal
and child well-being. However, research in Finland, Indonesia and India has
shown a clear negative correlation between antenatal visits and prenatal
mortality (Ibrahim et al. 2012). Studies looked at the effect of explicit ANC
variables on maternal and child healthiness outcomes. IFA and TT are two
major ANC measures that are of direct importance to the results of neonatal
safety. IFA supplementation during pregnancy could minimize preterm
delivery, enhance baby's birth weight and prevent birth asphyxia. Studies in
developed nations has demonstrated that preterm birth and low birth weight
lead greatly to neonatal mortality (Ngoc et al. 2006). The maternal injection of
Tetanus Toxoid offers passive defence of tetanus in the neonatal process of
the ANC (Ray et al. 2013).
Neonatal tetanus is a potential cause of mortality in LMICs (Lawn et al. 2005).
Research survey in China and Indonesia have shown an important decrease
in early neonatal mortality rates of neonates that have started to take iron folic
acid supplements, especially compared to those whose mothers did not
receive Iron and folic acid supplements or conventional folic acid only (Titaley
et al. 2010-2012). While Tetanus vaccination for pregnant ladies was
developed in the mid-1970s in WHO EPI: “Extended Program on
Immunization”, there is only little proof to support the effect of infant mortality.
Only one well-managed longitudinal review or single randomized controlled
trial has been performed in a systematic examination during the last year. The
review found that the immune response of pregnant females or pregnant
females of childbearing age at 2 doses of TT were predictable to decrease
neonatal tetanus mortality by 95% (Blencowe et al. 2010). As a result, a
primary potential drawback of study, which will have an impact on the
resulting impact assessment, lack of trials of higher quality. In India only two
small-scale experiments were investigated for the effects of a pregnant
women‟s immunization with neonatal mortality TT. The published findings
show a lack of robustness in the investigate conducted to explain the
connection amongst ANC diagnosis and mortality (Kumar et al., 1988). For
Instance, most of the research didn‟t analyse the specific consequence of
ANC therapy on neonatal mortality. Shah, and so on. For instance, (2000)
used the sum of antenatal care visits in the retrospective study, but did not
use any Iron folic acid supplements or TT vaccines in the research. However,
a large numeral of reviews didn‟t comprise recommendations for antenatal
visits or the amount of ionic folic acid ingested in their assessment. Much of
the previous work included details as to whether or not people were receiving
antenatal treatment or whether or not people expected IFA folic acid from the
network of health care during the ANC visits. With respect to the angle of
India, where the neonatal mortality is high, a protection impact of the studies
of ANC on the mortality is relatively small. Even if the rate of neonatal
mortality in India has decreased appreciably over the last two decades, in
1992-93 from 49 per 1,000 live births, to 39 in 2005-2006, the rates remain
extremely high (ORC Macro and IIPS 1995; 2007).In fact, there were major
differences in the rates of neonatal mortality in the whole countries and socio-
economic groups in India. Reviewing a relationship among neonatal mortality
or ANC interventions was specific imperative in poor settings of resources
such as India, an immediate is required for prioritizing the interventions which
provide full benefits in phases of maternal and neonatal health effects. In
absence of observational information on an effect of ANC treatment on
neonatal mortality, main purpose of the study is to examine these correlations
utilizing data from the District Level Household analysis of 2007-2008.
Since 2003, the UK has established and distributed National Evidence-based
recommendations in relation to antenatal treatment.They were revised in 2008
and re-examined again in 2011 when a new research was determined not
necessary to warrant a move.The next revision is expected in 2014.In addition
to full national clinical guidance
Accurate guideline to the health in maternity called to get complete benifits to
all the women and shall gain the healthy protection they, along with and safe
during period of all trimesters and even after birther of child. Healthy
motherhood covers social and cultural influences and assesses health policy
and health systems.Indicators used to assess maternal health such as
contraceptive prevalence rates, skilled attendance at birth, and maternal
morbidity as well as mortality. Maternal health enhancement is one of the
eight Millennium Development Goals, and substantial attempts to achieve this
objective have been made. But there is still a lot of work to do to ensure
women's maternal health worldwide.
BACKGROUND OF THE STUDY
The main issue of antenatal care is bringing a healthy mother and healthy
infant to the end of pregnancy. Antenatal treatment starts following conception
and progresses during breastfeeding. A healthy mother delivers a healthy
infant and has less probability of premature birth, stillbirth or abortion. Routine
antenatal treatment is the perfect use for proactive health resources. The goal
is to support and encourage the mother to maintain optimum well-being,
ensuring that the outcome of pregnancy and childbirth is beneficial for both
the mother and the baby. Through a money-saving perspective, pre-birth
treatment has proved itself convincing to reduce maternal death and
bleakness even as to boost perinatal results.
Many women do not have antenatal care in developing countries, almost half
have given birth without a trained attendant and most do not have postpartum
care. In particular, millions of women who are poor, uneducated, or living in
rural areas have no access to good quality of health care during
childbirth.Women in many regions still lack the power to make decisions about
their health and lives, with adverse effects on maternal health. They still have
lots of traditional beliefs about the food and regarding medical seeking.
High-quality maternal health facilities by skilled healthcare professionals
should be available and used to minimize life-threatening complications and
minimize mortality.Thus, safe motherhood interventions should be detailed in
nature, even if health facilities of quality are accessible,further restricting
factors may interfere with women who use these services, like cultural, social,
and economic factors.
Illiteracy is the largest obstacle for any change in the health condition.Also, in
the same socio-economic class, a mother's education level is a fundamental
determinant of the health of children.
Banerjee B8, (2009) states that, given that maternal mortality rates are high in
developed nations, the government country concerned needs to adopt some
programs to address the problem. She also points out that, on global terms,
minimum of 1600 females die every day from pregnancy as well as childbirth
complications, maximum of the cases occurring because of the modern
practices of people. Between 25-33% of fatalities of women in their
reproductive group of age in the countries that are still at developing stage are
the result of pregnancy and childbirth issues.
Apart from mortality, maternal morbidity is also of serious concern. In order to
address these problems and ensure maternal health, MCH services have
evolved from simple midwifery skills to the most integrated approach in the
form of the Child Survival and Safe Motherhood Program (CSSM) and later
the Reproductive and Child Health Program (RCH). The RCH Life Cycle
Approach stresses the need to maintain a positive health status from the pre-
birth date in order to ensure stable future generations. It needs a strong
standard of parental treatment, and is a core component of the RCH system.
High maternal mortality (301/100,000 live births) is a public health concern in
India. It reveals that 77 thousand people die every year owing to abortion and
childbirth-related reasons. NRHM (2005-2012) and RCH Phase-II (2005-10)
The Government of India has set targets for reducing maternal mortality by
focusing on four key aspects of essential antenatal and neonatal care for all,
providing qualified attendance at all births, and providing emergency obstetric
care for complicated cases. Referral services are provided for this type of
case. Quality antenatal treatment requires a total of 3 antenatal appointments,
2 doses of T.T. Immunization and 100-day intake of iron folic acid tablets.
Anaemia is reported to be more serious in pregnancy, 15-49 years of age
estimated to 57.8% of pregnant women becoming anaemic. 1 tablet (contain
0.5 mg of folic acid and 100 mg of elemental iron) is prescribed twice for
prophylaxis and anaemia care to both pregnant and lactating women for 100
days. Multiple doses of these pills and 24-hour monitoring systems are given
to all who have serious anaemia.
Janani Suraksha Yojana is another program to increase the efficacy of
antenatal care. This (JSY) is a healthy maternal initiative under the National
Rural Health Mission (NRHM) to allocate cash to vulnerable pregnant women
for institutional distribution. In this scheme, the ASHA link worker helps
pregnant women to make maternal care available and arrange for referral.
15
Coory, M. D., et.al., (2007) states that many high-risk pregnancies can be
better monitored and managed through antenatal services, and many other
conditions that are unwanted, such as genetic disorders such as Down
syndrome, can be detected early and pregnancy can also be terminated early.
In this review, the potential causes for Down pregnancy were established
according to the patterns observed. Which involve differential access to
antenatal screening, uncertainty regarding screening criteria and procedures,
late delivery of antenatal treatment, and disparities in attitudes towards
screening and termination of pregnancy among expectant parents. Antenatal
treatment is one of the main elements of the elimination in MMR and IMR in
the present scenario.
Dawn, C. S.17, (July 1994) describes that 400 mothers die in India for every
100,000 live births due to pregnancy, childbirth and post-birth complications.
The maternal mortality rate has decreased by only 10-15% over the last three
decades.
George Bernard Shaw.26 (2010, 17 May 2010). Now a new concept has
taken its origin, laying its foundation beyond the antenatal care named as pre-
conceptional care. In the article, "Take Care to Born Well," the author
describes that "the best time to start taking care of your unborn child is before
you conceive." Such care is called pre-pregnancy or pre-care. Means visiting
the doctor before planning to become pregnant, rather than after a missed
menstrual period. The doctor does the following: (1) takes medical history; (2)
performs some simple laboratory tests; and (3) performs a physical test. The
poor use of antenatal services reflects cultural and socio-economic constraint
and even perceptions of convenience of facilities and quality of care. It is
noted that the 64.00% of women not use antenatal services because they
regard it preventable; reflecting together the conventional approach that child-
bearing is not an event valuable of medical attention.
Lincetto, O., et.al. ,42(2018) said that optimal antenatal care coverage is a
successful story in Africa, as more than 2/3 of pregnant women (69 per cent)
has atleast one prenatal care contact.Nonetheless, in order to deliver the
maximum life-saving approach provided by antenatal services for mothers
and children, at least four antenatal appointments offering critical evidence-
based medication are needed. This program is also recognized as centered
antenatal services.
Essential resources in antenatal care include early diagnosis and treatment of
many obstetric complications, such as pre-eclampsia and TT immunization,
intermittent prevention of malaria during pregnancy, and diagnosis and
management of infections, with human immune deficiency virus, syphilis and
other sexually transmitted infections. In turn, antenatal treatment is a
opportunity to advertise the usage of professional birth participation and safe
habits include breastfeeding, premature postnatal treatment, and preparation
for the optimum utilization of contraception strategies as a maternity duration.
What do we improve the provision of priority treatments, particularly given the
current crucial lack of human capital for health in Africa? Are there clear
obstacles or threats to rising coverage and efficiency that should be conquer?
How can numerous programs that believe in antenatal care – malaria,
HIV/AIDS, tetanus total eradication and manage of sexually transmitted
diseases – be incorporated and strengthen the ANC vehicle instead of
addition to the existing burden?
PROBLEM
Better care during pregnancy is vital to the health of the women and therefore
to the growth of the unborn child. Pregnancy can be critical period for safe
habits and parental strategies to be promoted.
Good antenatal care is a mediator between the mother and her family,
providing a formal health care system, increasing the prospect of offering a
qualified child at birth and providing health care throughout the life cycle.
Inadequate treatment during that point removes the vital link within the
framework of treatment that affects both mothers and children.
Effects on mothers: which shown that 25% of maternal deaths happen during
the antenatal period, with disparities among countries measuring the
occurrence of illegal and unsafe abortion, domestic violence and disease
worldwide. About 3rd and 1⁄2 maternal deaths are due to conditions like
hypertension (pre-eclampsia and eclampsia) and severe antepartum
haemorrhage.
In 6 West African countries, 1/3th of every pregnant mother had deliveries or
antenatal diseases, 3 percent of which required hospitalization.
Many situations are becoming more serious during pregnancy. Malaria, HIV /
AIDS, anaemia and obesity are linked to increased maternal and new-born
mortality and even death wherever the frequency of this condition is elevated.
Novel evidence suggest that mothers suspected of having undergone
feminine genital mutilation are considerably more probable to experience
difficulties in childbirth, so that these individuals have been detected through
ANC. Gender-based violence and revelation to occupational vulnerability are
recent and sometimes ignored public health issues.
The rate of sadness may atleast as high, if not high, in delayed pregnancy as
in the postnatal era. Many African societies conclude that it is not necessary
for a stillborn infant to have a child dying in the last three months or the last
trimester of pregnancy that is difficult to precede and remember.
Results on foetuses in sub-Saharan Africa have shown that approximately
900,000 children perish as stillbirths throughout the last twelve weeks of
pregnancy or the last trimester of pregnancy. Tentatively, it is considered that
2/3 of all stillbirths have occurred in countries wherever death rate is higher
than 22 per 1,000 live births in all African countryside. Antepartum stillbirths
have seen different causes, such as maternal diseases such as syphilis and
complications during pregnancy, but there are no general causes of
antepartum stillbirths. New-borns have preterm pregnancy problems and
limited foetal development, and even other factors affect baby growth
and growth, like congenital infections in infants and foetal alcohol syndrome.
Economic, social and cultural behaviours and beliefs have a beneficial or
negative impact on well-being during the reproductive process or by
conception.
Some cultures endorse specific diets and rest for pregnant mothers, but in
others, breastfeeding is not as required. Through among cases, mothers who
are still affected by nutritional taboos can remove others important vitamins,
adding to several nutrient deficiencies during pregnancy, in particular iron,
protein, or certain vitamins. In one tribe in Nigeria, young people cannot claim
they 're breastfeeding, so if they don't feel right, they have to claim they need
to suck a cockroach. This section details the ANC kit, underlining the change
to a four-wise model of customized antenatal treatment for the majority of
children.
We illustrate the existing overall coverage or practice in Africa and explore
facilities to enhance antenatal care at the hospital or clinic, both within and
outside the community. At the end of the day, they recommend concrete
solutions to support and resolve significant problems in delivering quality
treatment to moms and babies during crucial maternity circumstances and to
combine various delivery methods and services targeted at this situation-
based era.
NEED FOR THE STUDY
In India, maternal mortality rates are strong relative to other developed
countries. And it is recognized that antenatal treatment is very important for
the reduction of MMR. Many reports have shown that racial inequality,
deprivation, illiteracy have a huge effect on antenatal treatment. Combating all
of these issues (IECs) of information, education and communication is an
important step. This research therefore aims to determine the expertise of
primigravida mothers in the field of antenatal treatment and to provide
mothers with the requisite information and education. Primigravida mothers
are selected as a population for this study, taking into account factors such as
no previous pregnancy and work experience, minimal exposure to antenatal
care knowledge, early marriages that may result in adolescent pregnancy.
Factors such as socio-economic history, i.e. employment, schooling, type of
family, mothers' health practices, dietary preferences, equality, have a
significant influence on their awareness and experience of antenatal
treatment.
The basicinformation about the antenatal care to the pregnant women along
with the complianceis equally matters a lot to avoid mortality rate and
morbidity at maternal andinfant site. The traditionalculture of the society of
India is possibly made up of various groups. Possibly the perceptions of these
groups are various from each other about the antenatal care and the health
care system, usually, The disparity of their knowledge and practice has to be
assessed forimproving the delivery of such services to these groups.
According to Sen, G.,et.al78 of the various studies published in the paper
"Maternal and Neonatal Health: Surviving the Roller Coast of International
Policy" (2007), author says, " Women do notdie throughout pregnancy and
childbirth as that is critical to adjust, but societyrelated issues are unbearable
to surveillance for them and the traditional culture surrounded by them makes
life difficult to survive and make life compatible with the society. Today's
reality is to ask the question about the importance of a woman's life in this
world and how worth it is.
"(Fathallah Mahmoud).Maternity, as Professors Fathallah so clearly put it, "is
not a disease... Pregnancy and childbirth are a fortunate feature of women,
necessary for the existence of our community... unique in the sense that it
should not be associated with other burdens of disease" He further describes
the interlinkages among maternal mortality and girls' education. Whereas the
well-being of a mother is extremely significant for infants and young children,
a few other studies indicates that it is necessary for the well-being of young
adolescents as well. However, individuals who research less prone to fail
through childbirth. The cause of schooling on the reduction in the number of
births means that every additional year of education, 2 maternal deaths per
1,000 women will be prevented. Investigate has also shown that maternal
mortality is also minimized with improving understanding of healthcare
services, the utilize of healthcare services in pregnancy and childbirth,
enhanced nutrition and increased space between deliveries, both of which are
fostered by women's education (UNICEF 2004). Prenatal treatment is also
influenced by maternal wellbeing and the health care network. Safe
motherhood initiatives will improve the effectiveness of the health care system
(World Bank 1999). The health system has the following advantages. Firstly,
by helping people escape premature abortion and seek early care for sexual
health issues, millions of early deaths will be prevented. Second, enhanced
maternal health services could strengthen the whole health care system.
Lastly, the strengthening of maternal health services could encourage
precautionary care services. A woman firstly pointed the contact with health
services are often in the occurrence of pregnancy and childbirth. This gives
people the ability to provide guidance on family planning and sexually
transmitted infections and to manage certain infections.
UN Millennium Initiative (2005) notes that deprivation is another aspect that
affects antenatal treatment. Tom, and so forth. Al. Al. (2004) The usage of
data from 11 household review in 10 developing nations indicates that, with
growing poverty, the proportion of women suffering from maternal reasons
has steadily risen. In one of the countries, Indonesia, 32-34% of maternal
deaths arise amongst women in the wealthiest and 20% of the country, with
maternal deaths 3-4 times high in the poorest quintile contrast to the richest.
As of 1981, maternal mortality in low-income nations was estimated to be just
around 300 for every 100,000 live births (Rosa 1981). In case of maternal
health, the following predictors cover a range of factors, with maternal age,
parity, access and utilization of ANC, accessibility of crisis obstetric care and
qualified attendance at delivery. The root causes lead to a variety of core
social and economic factors, with gender disparity and poverty, that enhance
women's liability to maternal ill-health and death. Clearly, these factors need
to be discussed. Barring additional attempts to address iron deficiency
anaemia. Policy focuses on the immediate environment of ANC, protected
delivery, and postnatal care. Successful referral and delivery of immediate
obstetric treatment in situ is the safest option (Wag and Claeson 2004).
Van Lerberghe and de Brouwere, (2001) explain the differences between
countries in the existence of dissimilar combinations of technical and political
factors – the coverage with which information is available on the dimensions
of maternal mortality, the devotion of communal officials to public health and
their ability to act on the information available, as well as the option of a
combination. (Kjeldstad, 2001). Several of the low and middle-income
countries which has observe gradual decline in maternal death in current
decades, Cambodia, Sri Lanka, Kerala, India. Costa Rica, Cuba, China – 2
factors seem to has work. Moreover, the planet has massive movement with a
strong political commitment to promoting public safety, or there have been
areas where gender differences have not traditionally been so large. These
were also countries with a high overall commitment to well-being, employment
and economic development.
Conclusion:
From all above it is felt that enhancing the standard of antenatal care will
strive to educate mothers regarding the various facets of antenatal care.
There are various factors which influence the antenatal care; hence it is
important to take into consideration of all those factors while providing
antenatal services to the pregnant mothers. It is proved that from many
research studies that MMR was declined since last three decades with the
effort of governmental policies for improving the quality of antenatal services.
Although there are also mothers who do not allow use of all such facilities, the
re are mothers who have been given birth at home and who suffer from compl
ications of pregnancy and function. The present research therefore aims to de
termine the awareness of primigravida mothers with regard to antennatal are
and to provide health information to primigravida mothers with regard to anten
natal care in inadequate areas.
TITLE:
“A study to assess the effectiveness of planned health teaching on
knowledge regarding antenatal care among the primigravida mothers in
selected hospitals of Aurangabad city”.
OBJECTIVESOF THE STUDY
1. To assess the knowledge of primigravida mothers regarding antenatal care.
2. To develop and administer planned health teaching to primigravida mothers
regarding antenatal care.
3. To assess the effectiveness of planned health teaching on knowledge of
primigravida mothers regarding antenatal care.
4. To correlate the knowledge score with selected demographic variables.
OPERATIONAL DEFINITION:
Assess:As per the Oxford dictionary, toassess or measure the value, significa
nce or quality
In this study, includes evaluate the quality of planned health teaching.
Effectiveness: According to oxford dictionary, Effectiveness implies testing
the desirable effect of the expected outcomes or the outcome.
In this study, Effectiveness implies the outcome of the planned health
teaching in terms of testing the optimal antenatal Care Awareness Score
amongst primigravida mothers.
Planned Health Teaching: As per oxford dictionary, planned teaching
Means, “giving systematic information to people that may enrich their
knowledge”.
In this study, Means a meaningful systematic interaction between
investigator and the primigravida mothers about the antenatal care.
Knowledge: According to the Cambridge learner‟s dictionary, “knowledge”
refers to the information and understanding that you have in your mind.
In this study, Knowledge signifies the information and understanding that
primigravida mothers have regarding antenatal care.
Antenatal: According to oxford dictionary, before birth, during or relating to
pregnancy.
Care: According to oxford dictionary, the provision of welfare and protection
Antenatal care: In this study: Systematic supervision (evaluation and
counseling) of pregnant women is termed antenatal care.
SCOPE OF THE STUDY
1.Adequate knowledge regarding antenatal care helps to reduce
complications during pregnancy, labor and ensure delivery of a healthy baby.
2. Educational programs can be planned for primigravida mothers according
to their need and level of understanding.
ASSUMPTIONS:
The study assumes that:
1. Primigravida mothers have some knowledge about antenatal care and
planned health teaching will help to improve their knowledge concerning
antenatal care.
2. The planned health teaching program can be useful to upgrade knowledge
on Antenatal care.
HYPOTHESIS:
Kabir, Syed Muhammad.36 (2016). According to the author, he said about
hypothesis that, “We usually not initiated for a one-step forward without prior
logical and satisfactory suggestion along with the proper explanation or
solution of the issues raised. that kind of probable explanations are mostly
suggested to us on the basis of existing knowledge of someone and those
subject-matters. When they are formulated as propositions, theyare called
hypotheses. Note, the provided hypothesis (plural hypotheses) considered as
a probable solution to a problem. The research activities are always planned
to check the probable hypothesis and but not to get the solution for the
defined problem or to seek an answerto a respective question. Important to
understand the research scholar the importance and meaning of
the hypothesis. Always in the beginning of the problem, the researcher plans
or formulate ahypothesis.
This concept consists of two words: hypothesis + hypothesis = hypothesis.
'Hypo' is a preliminary or checked argument, and 'Thesis' is a problem-solving
argument. The word sense phrase of hypothesis is a preliminary statement
about solving problems.
Hypotheses give a solution to the dilemma which must be tested empirically
and justified. Two words - Hypo means two or more factors to be confirmed -
are also the meaning of the term hypothesis. 'Thesis suggests that certain
variables are set inside the same reference frame. This is the operating value
of the philosophy.
The theory is that variables that are to be verified empirically are composed
and have a specific location or function of the variables. This is a comment on
the factual and philosophical dimensions.
Hypothesis is termed a Deep Jump. It's a brilliant conjecture about a problem
solving.
A hypothesis is an assumption about the correlation among the two variables
or more. A hypothesis is a preliminary, proven guess of what the study
expects to happen. Three components - the variables, population and the
relation between factors - must then be included to complete the theory. You
don't need to know a conclusion. The research target, however of concluding
whether or not this conjecture is right, predicts what the researchers intend to
find. When carrying out an experiment, investigators can explore a list of
various variables which may lead to the final result. Researchers may note, in
certain instances, which the findings of an experiment may not support an
original hypothesis. The researchers may consider other choices while writing
such findings, which must be discussed in future research
Hypothesis: There is a different hypothesis both of these. It is the assumed
argument that the prosecutor is trying to prove of a proposition. It is a
systematic condensation. Such generalization includes knowledge of the
principles of items or essential features relating to the whole class of
phenomena. The method is described as hypothesis when presented
explicitly and specifically as a testable concept, and subject to analytical or
experimental proof. The theory begins the germinal foundation for the whole
case, that continues to be confirmed by proof. The idea depends on an earlier
used principle and few reasoning as the postulates were assumed valid with
guaranteed. The supposed solution of a significant problem is an assumption.
Partially, that might be valid.
The method of science study is focused upon such theories. The essence of
maths and sciences is focused on postulates. The estimates are depending
on certain assumptions that are called science-approximate. The findings are
useful when conducting a behavioural science explore study.
The author identified hypothesis functions and roles that,
"A hypothesis, that is a tentative term, has a substantial part in scientific or
socio-legal science. This navigates work in the right way but also leads to
evaluating or proposing hypotheses and explaining a problem that is social or
legitimate.
Role of hypothesis in exploring studies "A hypothesis implies how the author
is looking for, regardless of source. It provides any plausible reasons about
possible interactions among the definitions or factors shown in it. It ultimately
navigates the study. "Without this, empirical research or non-doctrinal legal
research cannot take any further move. A theory lets the researcher draw
'meaningful conclusions' which are confirmed by scientific 'relevant' data. A
theory acts as a solid reference to: I the form of data to be gathered to
respond to the research problem; (ii) the most effective and practical means of
organizing the data; and (iii) the type of techniques that can be used to
analyse the data. Function of 'proven' hypothesis: To make any inferences
about the originally presented relationships among the variables suggested in
the experiment, a hypothesis has to be empirically tested. Therefore, after
empirically tested (or not checked), the originally presumed association, as its
case could be, between the principles or variables becomes a proven fact.
Once a theory is formed, the hypothesis ceases to be.
The following important functions often execute a hypothesis-
Test theories: A hypothesis helps us to test a presented theory when it has
been empirically proven. A concept is not a mere speculation, but one based
on facts. It is a set of interrelated statements or intentions assembled into a
deductive system that provides an interpretation of some phenomena.
Reality comprises a hypothesis once collected, organized, and presented in a
context. Thus, while hypothesis is “tested”, it directly not supports the current
theory which responsible for the explanation of a definite social phenomenon
and then 'tests' it in a way.
Support new theories: Anytime when hypothesis, while linked to any
established theory that disclose some 'facts' after it has been checked that are
not connected to the present theory or reveal relationships other than those
mentioned in the theory. It doesn‟t support the current hypothesis yet
proposes a new theory.
Define social phenomenon: A descriptive function often exercises a theory.
Through when a theory is empirically tested it teaches us impressive about
the underlying phenomena. If empirically supported the hypothesis then our
information on the phenomenon enhance. Even if the argument is debunked,
the data tell us something about the above phenomena.
Suggested social policy: After its testing, a theory can highlight certain 'ills' of
current social or legislative policy. In such a case the theory that has been
checked lets one devise (or reformulate) a social policy. It may also
recommend or propose likely solutions to and their execution of the existing
social problem(s).
In the scientific studies the theories play a significant role. Here are a few of
the hypotheses' essential role and functions-
It assists in checking the hypotheses. It serves as a great investigation forum.
It gives guidance for the research or study work. Sometimes it suggests
theories through hypothesis. Helps them to know the data needs. It illustrates
sociological phenomena. It begins to develop the theory. This often serves as
a link between science and theory. This provides a connection between
experiences very so that this often contributes to the relationship's scientific
checking. It helps in deciding the analytical technique which is most
successful. This allows this possible to decide among the most advanced
study type. It provides information about the necessary data sources. Under
the framework of the theory, study has become reliant. This is really helpful to
bring an enquiry out of a specific incident. This helps in making assumptions
when considered right. The analysis method proposed by Mc Ashan includes
five core roles of hypothesis. -
1. This is a impermanent way out to a question related to any reality that
assist a investigator to carry on the his / her analysis.
2. This offers a structure in favour of checking the parameters on what to
analyse, that can include potential approaches to the issue.
3. Every hypothesis might contribute for the future hypothesis for being
formulated.
4. A tentative theory could take the form of the final assumption.
5. Hypothesis offers the investigator a definitive argument that could logically
checked and accepted or dismissed, that contributes to the analysis of
findings and drawing of conclusions relevant to the original intent.”
Further they focused on significance of Hypothesis that
“Hypothesis as the Investigator‟s „Eyes‟: By guiding the investigator in further
investigation it serves as the investigator‟s „Eyes‟ in seeking answers to
tentatively adopted generalization.”
This Focuses Analysis: Analysis is scattered work without it and stays like a
wild scientific searching. It serves as a critical connection between research
and theory.
It areas Clear and Specific Goals: Some well-thought-out set of hypotheses is
that they set clear and specific goals even before qualitative researcher and
provide a basis for the selection of sample and research processes to meet
these goals.
It Links Together: This performs the essential purpose of connecting and
grouping relevant information into wholes.
It Avoids Blind Research: The usage of hypothesis prohibits a random quest
and indiscriminate compilation of volumes of data that could later appear to be
unrelated to the question under investigation.
As a kind of guiding light: a hypothesis acts as a significant beacon for the
research work to illuminate those lights.
George J. Mouley believes that the preceeding purposes are served by
hypotheses – they offer direction for research and prevent the evaluation of
insignificant literature and collection of effective or excess data. We stimulate
the researcher for other psychological considerations that are meaningless
from the point of view of the issue at hand. We help the investigator to
consider his / her question and implications with better transparency.
That serves as a framework for the definitive-in brief, a good hypothesis: (a)
Gives help in determining where to go. (B) It assists in selecting relevant
facts. (C) Aiding in forming assumptions. Van Dalen supports theory relevant
in the following states-
Hypotheses are important method for science, since they create a connection
between the issue and the source of scientific data that can fix the question. A
hypothesis serves as a road map which guides and expedites the
phenomenon under consideration to be explored. A pin on the theory points to
the issue. The researcher may thoroughly examine the empirical and
philosophical elements which relates directly to a topic. The use of hypothesis
decides what evidence are important. A theory leads the actions of the
researcher into successful canals. The theory not only suggests what an
inquiry is to be searched for but also how to collect information. It helps in
determining architecture for the study. Which topics, experiments, and
techniques are required may be suggested. The hypothesis presented the
researcher with the most effective instrument for investigating the unknown
facts and describing them. A theory offers the basis that conclusions can be
drawn. The researchers are simulating these theories for further studies
conducted.
Characteristics of a good hypothesis
A successful hypothesis must have the following options-it has never been
conceived in a problem type. If it is correct or wrong, it must be empirically
testable. It must be clear and accurate. This is not to say inconsistent. It
should define the variables to create the relation between.
It may only explain one question. A theory can be constructed in either
concise or relational manner. It does not sound in accordance with any law of
nature considered to be valid. This ensures that the tools and techniques
would be utilized successfully for verification purposes. In the simplest terms it
should be explained far as possible, so that all involved can easily identify the
same. Should explain the facts which gave rise to the need for clarification.
Testing must possible within a reasonable period of time.
A 'workable' or 'usable' theory will be the one that satisfies all of the
parameters below. Structurally, the theory must be clear: The principles
utilized in the hypothesis must be obviously outlined, not only officially but
also functionally, if necessary. The formal definition of the terms would explain
what a research method stands for, whereas the operational definition would
leave little doubt as to what the empirical evidence or principle predictor on
the plane of reality will mean. Observably, an ambiguous or ill-defined
definition renders evaluating theory challenging or even impractical for the
researcher because there would be no specific framework for the researcher
to learn the empirical evidence. Nevertheless, a researcher will use, when
describing definitions, it should be described as much as practicable in the
simplest terms such that those involved can be readily understood. Scientists
are not expected to build 'a private word universe.'
Theory must be specific: When formulating a theory no abstract or value-
judgmental words can be used. The posited correlation should be specifically
stated. This will contain a clear description of all the forecasts and activities
suggested therein and they should be written out specifically. Specific
hypothesis development means that work is both feasible and significant. It
serves to improve the legitimacy of the findings as the more precise the
argument or forecast, the less probable it would eventually be carried out as a
consequence of pure error or chance. Therefore, a investigator must bear in
mind that a narrower theory is usually more testable, and he / she can
establish such a presumption.
Hypothesis must be empirically testable: it has objective sources so that
certain rational conclusions and inferences concerning it can be deduced. A
study should therefore be extremely aware that his / her theory represents
concepts or variables of clear empirical consistency and not concepts or
variables filled with moral judgements or beliefs. Such arguments as
“criminals are no worse than entrepreneurs,”“capitalists exploit their
employees,”“evil parents beget poor babies,”“bad homes promote violence,”
or “pigs are well-named because they are so filthy,” may hardly be credible
hypotheses, since they have no empirical referents to test their authenticity. In
other phrases, in his theory, a researcher would stop utilizing vocabulary filled
with values or beliefs, or phrases that have religious or disposition
connotations.
hypotheses must be linked to the techniques applied: the investigator could
be ignorant of the available techniques, rendering him/her ineffective in
constructing a workable hypothesis. Therefore, a theory only needs to be
developed after sufficient consideration is given to the methods and
techniques which could utilized to quantify the principles or variables
integrated in the hypothesis.
Hypothesis can be related to a spectrum of theoretical or other theoretical
approach: after the hypothesis has been tested the current theory is only
confirmed, supported, corrected or refuted whether it is related to a certain
theory or has a certain theoretical orientation. This imaginary hypothesis not
only evolves and enhances contemporary philosophy, but may also have
important links with many other theories. Consequently, it may also offer an
opportunity to draw hypotheses from a body of theory for a scientific leap into
new fields of information.
A theory-derived hypothesis invests its creator with the predictive power of
their future.
In terms of statistical intent, the efficacy of the theory signifies a significant
advance in scientific understanding. For such a theory, a sincere contribution
to science is more likely to happen. A theory, it is suggested, to be favoured is
one that can foresee what could occur, and from that we can conclude what
has already occurred, even though we did not realize when the theory was
developed (it had occurred).
Sources/Origins of hypothesis
Hypotheses derive by exactly same perspective which helps to expose
question. Such origins are theoretical background, expertise, intuition and
creativity that emerge from instructional process and wide-ranging experience
with training, acquaintance with the present practice. Main sources of
assumptions werelisted as-
Specialisation of the field of education.
Research studies, abstracts investigatory papers, textbooks, problem
workshops, recent research patterns. Convinced training services.
Study of study region.
Consideration of the current needs and practices.
Extended review.
Off-shoots from field research studies.
Researcher uses these tools to devise his / her forensic theories. In
formulating a theory, she / he must use two logical processes to build from.
The systems are referred to as-
(A) Deductive thought; and
(B) fortunately, the inductive reasoning theory has a significant which bear on
essence of the input in the knowledge base present. Below are some of
sources of speculation mentioned.
Intuition or Hunch: The hypothesis might literally be focused on a person's
Intuition or HunchIt's a new notion sort of. If evaluated, a certain hypothesis
will potentially provide a substantial difference to the current science or body
of information. Nevertheless, it relates to two drawbacks when a theory is
evaluated in one particular sample only. Second, there is no guarantee that in
other experiments, the association formed among the two variables integrated
in the hypothesis is identified. Second, the findings of such a theory are likely
to be contrary to other hypotheses or the body of research, or irrelevant. It is
probable they would stay isolated bits of knowledge. Such observations can
however pose important concerns worth exploring. They can encourage more
study, which may fit into an exploratory approach if corroborated.
Additional results: A theory can derive from findings of other studies or tests.
Clearly, a theory based on the results of experiments is clear of first
restriction, that is, there is no guarantee that this could be linked to other
studies. When such a theory is confirmed, it supports results from earlier
research even as it imitates earlier experiments carried out in specific
empirical situations.
A theory or a theory body: The concept can emerge through an established
model or a theory body. A theory defines logical deductions of the correlation
between proven facts which are interconnected. A investigator may propose a
hypothesis for checking or reconfirming the relationship, forecasting or
suggesting such correlation between the facts or propositions interlinked in a
hypothesis. Through explaining what is understood a hypothesis gives
direction to science. Logical conclusions from such facts known which might
lead to the formation of another hypotheses.
General popular culture: It includes all fundamental theories. Particular value-
orientation in society produces a variety of empirically testable claims in the
form of theories, whether it attracts the interest of social scientists through
their close study.
Analogy: This is amongst the root of viable theories. Analogy create useful
new ideas. We also form a fountainhead with useful theories. Both casual
observations can be a rich source of ideas of nature or within the context of
another study. A known specific trend of human conduct might be a source of
inference in a series of situations or social environments. Across various
social environments, a researcher can be tempted to check certain formed co-
relations with similar characteristics. Investigator may be involved in
examining such analogies in a sort of specific contexts and conditions.
Researcher is finding guidance from equivalences of others to develop the
theory. Nevertheless, as a researcher utilizes analogy as a basis of his / her
theory, he / she ought to closely consider the historical context from which the
comparison was developed, and its significance in the current conceptual
system.
Human experience: The development of theories does not just concern
society, research and inference among others. One element in the declaration
of hypothesis is the way an person responds to each of these. Therefore, a
person's individual knowledge relates to the nature and shape of the
questions posed by the researcher, as well as to the types of preliminary
answers to such hypotheses (questions) which they may offers. Any scientists
may perceive a fascinating trend from merely existing to a common man as a
'jumble of truth.' Scientific literature is full of examples of observations
produced as it happens that the 'right' entity produced the 'correct' discovery
regardless of the researcher's actual social context, professional knowledge
or access to a complex series of events.
Personal experience of the Author or the life background can affect their
interpretation and conception, and it effects to guide any hypothesis very
readily to be formulated.
Thus, a theory may come from a number of outlets, either alone or in
conjunction with another. Among these abundant origins of theories, though, a
practical or workable theory is not quickly formulated. Getting a problem is
also easier to identify and articulate than overcoming it. If an investigator
achieves in formulating a theory, he / she should be able to guarantee that
was half-solved.
When forming a theory, the author must keep on remembering that he / she
will formulate preliminary theory in a manner which it would be useful in a
systematic analysis.
Types of hypothesis
A research hypothesis has to be developed before researchers can start
focusing on a topic that concerns them. It is an essential phase in the
experimental process, since the course of the research is decided. Scientists
ought to scrutinize historical research in the field and pick an experimental
method to utilized to help them locate evidence that either confirms their
theory or denies it. There are various forms of testing hypotheses: easy,
complicated, directed, alternative, null, deductive, inductive,
explanatory,associative, and non-directional study.
Simple Hypothesis: It estimates a correlation among an Independent
and single dependent (DV) variable.
For illustration: Lower postpartum activity rates are correlated with greater
retention of weight.
Complex Hypothesis: The association among two or more independent
variables and two or more dependent variables is expected here. Instance of
a dynamic multiple independent variable theory-pregnant people that are low
risk (IV)
Who strongly supports health; who believes that participating in health-
promoting practices can contribute to beneficial outcomes; who perceives less
obstacles to health-promoting activities; are far more likely to attend
pregnancy-related education programs (DV) than other participants? Another
illustration of a nuanced multiple dependent variable theory-the introduction of
an evidence-based urinary incontinence treatment (IV) would lead in (DV)
decreased occurrence of urinary incontinence episodes; reduced urine
leakage per episode; reduced avoidance of female outpatient care events.
Directional Hypothesis: It may mean that the investigator is dedicated
scientifically to a single result. They define the predicted course of a
correlation among the variables, the researcher forecasts not just the
presence but also the essence of a relationship. This type of hypothesis is
widely used in science journal papers. The investigator is basing this theory
on the obvious patterns in this area from previous studies. Regarding the
context, an investigator that describe the hypothesis as, “High school students
who take part in extracurricular practices has a lower GPA than those that do
not take part in those activities”. These hypotheses offer a definite path for the
forecast.
Nondirectional Hypothesis: This type of hypothesis is implemented in
research when there isn't enough previous work to base a conclusion on.
Don't stipulate the link path. Continuing with the same case, a non-directional
theory will say, 'High school students' academic success is linked to their
involvement in extracurricular activities."
Associative Hypothesis: Associative hypotheses suggest interactions
between variables, the other shifts as one variable changes. Don't explain
cause and effect.
Causal Hypothesis: Causal hypotheses suggest an association of cause and
effect involving two or more factors. This manipulates the independent
variable to trigger influence on the dependent variable. To analyze the
influence produced by the independent variable the dependent variable is
calculated. In the illustration described, the causal hypothesis would say,
'High school students who partake in extracurricular activities spend fewer
time learning that contributes to a low GPA.' While testing these theories, the
researcher has to use experimental methods to show the existence of a
cause-effect connection. These theories often enable the interviewer to rule
out the likelihood that the impact can arise from a source except what the
analysis has looked at.
Inductive and Deductive Hypotheses: Inductive theories are created by
inductively inference to preliminary reasons from several different findings to.
Deductive theories are created by abstract consequences of the deductive
reasoning.
Null Hypothesis: It is a hypothesis which does not suggest some relation or
distinction among two variables. That's the traditional predictive method. It
requires a declaration that means there is no interaction between two classes
evaluated by the researcher on a given item. The theory can therefore claim
that there is no substantial variation with regard to a single feature when
various populations are contrasted. For instance, a null hypothesis is 'There is
no difference between the academic success of high school students
engaging between extracurricular activities, and those not involved in those
activities.' This argues that there is no real variation between the survey
numbers and population parameter being regarded (hence the term 'null'
meaning invalid, void, or mounting to nothing) and that the disparity observed
is unintended arise from sampling fluctuations. It's called H0. Rejecting the
null hypothesis suggests that the variations are statistically important, and
adopting the null hypothesis implies that the discrepancies are due to chance.
Alternate or Research Hypothesis: This theory suggests a partnership,
symbolized as H1, among two or more variables. For instance, if a
investigator was interested in exploring the connection among music and
emotion, he / she would believe music and emotion are connected.
H1 (Research/Alternate Hypothesis): Participants perceive music on an initial
level of tempo as comfortable than music at a sluggish speed.
H0 (the null hypothesis): Participants score music at a high pace and sluggish
pace the same in satisfaction.
The two theories that we are attempting to evaluate should be equally
exclusive; i.e. someone else must be incorrect while one is true. So we know
they have to be exhaustive; they have to cover any imaginable event.
Statistical Hypothesis: It is an assertion where one tries to help or contradict
the mathematical populations. The combination null hypothesis and alternate
hypothesis is considered statistical hypothesis.
HYPOTHESIS: in this study,
H01 - There will be no significant enhance in knowledge regarding Antenatal
care among the primigravid mothers after the planned health teaching.
H1- There will be significant enhance in knowledge regarding Antenatal care
among the primigravid mothers after the planned health teaching.
DELIMITATIONS:
1. Primigravida mothers able to attend antenatal OPD in selected hospitals in
Aurangabad City.
2. Selected features of antenatal care are included in this study (diet,
immunization, supplementary therapy, antenatal exercise, antenatal visits,
personal hygiene, and breast care)
3. The research will be limited to those primigravida mothers who are able to
engage in this analysis.
4. The study will be limited to the population who read, writes and
understands English, Marathi or Hindi.
ETHICAL ASPECT:
1. The proposal for a study was endorsed by the College's Ethical Committee.
2. No Permission has been received from the responsible authority of the
listed Aurangabad hospitals.
3. Informed consent has been taken from the participants.
CONCEPTUAL FRAMEWORK:
Conceptual frameworks are used to test theories based on clinical
experience. Models are methods to look effectively at the conditions of the
consumer that allow them to improve their reasoning, conclusions and
perceptions. The templates are systematically structured along these lines
which contribute to efficient which convincing clinical practice. Model serves
as a bridge between nursing practice, study and teaching. Models will also fill
in as a reason to inquire about them. The conceptual system speaks to a less
proper effort to sort out a wonder.
The conceptual structure for the present review depends on the framework
model, which will disclose the ideas identified in the present investigation and
provide adequate assistance in assessing the impact of the intercession.
Model segments are input, output. The framework is formed with respect to
the understanding of a person that would make a health visit in the person
feels that better use of antenatal administration can maintain a strategic
distance from pregnancy entanglements and have a positive pregnancy
outcome as far as healthy mothers and healthy chiles are concerned. The
system model refers to certain activities that the person does voluntarily, for
the remainder of his or her life, to progress and hold near to home prosperity.
Ludwing Von Bertalanffy developed the general framework hypothesis. The
framework is a set of integrated and shared parts that work all in all. The
logical framework is separated into three levels of entry, performance and
output.
Input:
Input was described as any kind of knowledge and material that enters the
system via a boundary in this analysis by comparison to primigravida mothers
with demographic variables Gender, Period of marriage, Gestational periods,
No. of antenatal visits, Registration date, Monthly family income ,
Employment, Occupation, Religion, Habits, Family size, Nearest health care
facility In this analysis, their initial awareness will be tested by a pre-test
focused on a semi-structured questionnaire between participants.
Throughput:
Due to this definition, the mechanism is a phase that takes place at some
stage during the input and output method that allows the input to be
incorporated into the execution of the proposed health education for
primigravida mothers on antenatal treatment.
Output:
Output is data and information that is transmitted to the world in this analysis;
output applies to the accumulation of awareness scores in the primigravida
mother post-test. The post-test will take place 8 days after the distribution of
the proposed health education for primigravida mothers on antenatal
treatment.