Assessment of Antenatal Care Services among Pregnant Women ' s in Al-Hilla City تلحلا تنيذم يف لماوحلا ءاسنلا نيب ةدلاولا لبق تياعرلا ثامذخ مييقت

-1Assessment of Antenatal Care Services among Pregnant Women's in Al-Hilla City تلحلا تنيذم يف لماوحلا ءاسنلا نيب ةدلاولا لبق تياعرلا ثامذخ مييقت  Ali F. Abdul Hussein, M.S. College of Nursing / University of Babylon. Ameen A. Yaser, A. Prof., College of Nursing / University of Babylon. G-mail: ali.alsaadi42@gmail.com :تصلاخلا  تيفلخ  ثحبلا :  .تهحنا تُيذي يف تيببدَلإا تيشًؼنا تئفنا يف ءبسُنا فٕفص يف ةدلإهن تقببسنا تيبػشنا ٍي ةدبفخسلاا تفشؼي قحٔ ي ىي  تيبػشنا ثبيذخ لإهن تقببسنا تيبػشنا ثبيذخٔ ميإحنا ءبسُنا ثبخبيخحا تيبهحٔ ثبيذخنا ىيذقح تينبؼف ضيضؼخن بًيس لأ تيًْلأا غنبب شيأ ةدلإنا مبق .ةد  :فذهلا  ييقخن ى  ا ثبَبيبنا غي ةدلإهن تقببسنا تيبػشنا ثبيذخ ٖٕخسي ٍيب تقلاؼنا ذيذححٔ ةدلإهن تقببسنا تيبػشنا ثبيذخ صئبصخٔ تيفاشغًٕيذن يحص خيسبخنا ذيذحخن  تيذقًنا ثبيذخنا ٖٕخسي ٍيب تقلاؼنا  صئبصخنا ِزْ ٍيب .  تيجهنملا :  جيشخأ  ٌَٕبك ٍي يَبثنا ٍي ةشخفهن تهحنا تُيذي يف تينٔلاا تيحصنا تيبػشنا ضكاشي يف ّيفصٔ تساسد لٔلأا  4102  ٍي ششبؼنا تيبغنٔ سبيا 4103  )تيضشغ ( تينبًخحا شيغ تُيػ جؼًخ ٍي 441 ميبح ِاشيا يحإهنا  خاشي ؼ ثبَبيبنا جؼَ ًِ خُٔ ،تهحنا تُيذي يف تيحصنا ضكاشًنا ٍ  ٍي ةسٔبحًنا تيُقح واذخخسببٔ بٓحببثٔ بٓقذص ذيذحح ذؼب بْشيٕطح ىح يخنا تَببخسلاا واذخخسا للاخ تَببخسلاا ةسبًخسا ثببث ثدذح . ميإحنا ءبسُنا غي للاخ ٍي ءاشخأ  ( ٍي تَٕكي تػًٕدي للاخ ٍي بٓخيقاذصي ثدذحٔ ةشغصًنا تساسذنا 01 ) ّىح .شيبخ  يفصٕنا ءبصحلإا قيشط ٍػ ثبَبيبنا ميهحح  يهيهحخنا ءبصحلإأ .  :جئاتنلا يئبُٓنا ىييقخنا ٌإ تساسذنا حئبخَ ثشٓظأ ٖٕخسًن تيبػشنا  ةدلإنا مبق بي  ٌبك ظسٕخي  تبسُب 31.1 .%  جاتنتسلاا : ( ٌبب تساسذنا ِزْ ٍي حخُخسَ ميبحهن يحصنا خيسبخنأ تيفاشغًيذنا ميإؼنا بٓن ) شيثأح  ٗهػ ةدلإنا مبق بي ثبيذخ .  :ثايصوتلا ةسٔشضب تساسذنا جصٔأ تيحصنا تيبػشنا ضكاشًنا داذػا ةدبيص تينٔلأا  ةذيذخ  يَبؼح يخنا تيحصنا ضكاشًنا ٗهػ مصبحنا ىخضنا مهقخن تينبػتيَبكس تفبثك ٍي  تحصنا تًظًُن ةدلإهن تقببسنا تيبػشنا جرًَٕ عببحأ تينٔلأا تيحصنا تيبػشنا ضكاشي تيقبن تيفبك فشغ ءبشَإ ٗهػ ضيكشخنأ بُؼًخدي يف ثبٓيلأن تيحصنا تيبػشنا صضؼح يخنأ ميإحنا ثبفػبضي ٍي فشكٔ شكبًنا فبشخكلاا ٌأٔ ،مفطنأ ولأا تيبػس ثبيذخ يف تيًنبؼنا .  اتفملا ثاملكلا : تيح  ييقح ى ءبسُنا ،  ميإحنا  تيبُؼنا، ةدلإنا مبق .  Abstract:


Assessment of Antenatal
Recommendations:The study recommended the increase number ofprimary health care centers to reduce the momentum on health centers, which suffers from high population density and concentration to create enough room for the rest of the primary health care centers.Follow the previous model of care for the birth of a new world health organization in maternal and child care services, and that early detection and detection of complications pregnant and that promote maternal health care in our community.

INTRODCTION
Antenatal care (ANC) is an important health service, which detects and sometimes reduces the risk of complications among pregnant women.The quality of care is likely to influence effective utilization and compliance with interventions (1) .ANC is a combination of monitoring for problems in mother and fetus, treatments and preventive care, health education, support and advice for pregnant women.Until recently, antenatal care has been largely unevaluated.There is limited evidence on specific component of antenatal care, but there was, at the time of planning the study, little evidence of overall effects of antenatal and delivery care on mothers and their babies, either in developed or in developing countries (2) .
At each antenatal visit, midwives and doctors should offer information consistent advice, clear explanations, and provide women an opportunity to ask questions (3) .Given good quality and regular attendance.In addition, ANC attendance during pregnancy has been shown to have a positive impact on the use of postnatal healthcare services, which also play a key role in detecting risky conditions after childbirth consequently leading to better maternal health outcomes (4) .The availability and accessibility of modern health services in developing and low income countries have increased over the past decades.While the effectiveness in curing diseases may lead to greater utilization of modern health services compared to traditional practices, their utilization is likely to be higher among urban dwellers and those with higher socioeconomic status than by rural residents and groups with a lower socioeconomic status in developing countries (5) .The predictors of the utilization of ANC services in most developing countries include socio-demographic factors, availability and access to the health facilities, the educational level of the women and their husbands, perceptions of women regarding ANC and their knowledge of the importance of ANC services demographic factors such as the number of previous pregnancies, the number of on the utilization of antenatal care children, maternal age, and marital duration also are reported to have an influence ( 6) .

OBJECTIVES
The study aims to: 1.Assess of pregnant women's compliance about antenatal care.
2. Find out the relation between pregnant women's compliance about demographic data and maternal health history.

METHODOLOGY
Descriptive study was carried out through the present study in order to achieve the objectives.The period of the study is from December, 2nd, 2014 to May, 10 th , 2015.The study is conducted in Al-Hilla City/ primary health care centers.A Non-Probability (Purposive Sample) of ( 220) withpregnant women's , those who visited/ primary health care centers, were included in the study sample.The data had been collected through the utilization of the developed questionnaire after the validity through (13) expertsand reliability were estimated, and by means of structured interview technique with the subjects who were individually interviewed.Datacollection process has been performed from February, 1 st , 2015 until the March, 3 rd , 2015.Each subject takes off approximately (20-30) minute to complete the interview.

The study instrument
A questionnaire is adopted and developed by after extension literature review and review the articles which were related to this field.The final study instrument consists of three parts:

Part 1: Demographic Data:
A demographic data sheet, consists of (5) items, which included residency, age, level of education, occupation, and monthly income.

Part 2: Maternal health history:
The second part of the questionnaire is comprised of (5) items, which Primigravida, duration of pregnancy, abortion, complications, health education, and visits services provider.

Part 3: Antenatal care services:
This part of the questionnaire is comprised of (5) domains, including the registration servicesdomain, consists of (3) itemsdiagnostic and treatment servicesdomain, consists of (9)   items, laboratory test domain and consists of (6) items, meat, livestock and fish and consists of (6) items, tetanus vacation servicesdomain, consists of (3) itemshealth education and consists of ( 14) items (7) .
The statistical data analysis approaches was used in order to analyze the data of the study under application of the statistical package (SPSS) ver.(20), and the Microsoft excel (2013).Data were presented using descriptive the in from of frequencies and Percentages.Summary Statistics tables including: Mean, Mean of scores (M.S), standard deviation (SD).Relative sufficiency (R.S): used to assess of patients' compliance regarding therapeutic regime with coronary heart disease by three grades (good, fair, poor) scoring by (79-100, 56-78, 33-55) .Person's correlation coefficient: was used to estimate the scale reliability through the application.Chi-square test: used to find out the association between of the patient's compliance and their demographic data and clinical data     Table 4 showthat there was high significant difference in the overall antenatal care services with demographic data regard to their residency and monthly income at (P0.01),

RESULTS
shows that there wasnot significant (P  0.05) and it appears from this table that there was no significant difference concerning with their occupation and level of education at (P > 0.05).Table 5 shows that there was significant difference in the overall antenatal care services with maternal health history regard to their health education at (P0.01), it appears from this table that there was significant difference concerning with their gravida, duration of pregnancy, services provider, visits and complication at (P0.05) and shows that there was no significant difference concerning with their abortion at(P>0.05).

DISCUSSION
The findings of the present study show that the majority of the studied sample the age groups (20-24) years,this result is supported by another study in that they found that most of the study sample are within the age group of (20-30) years old (8) .A study was done in Iraq who found that majority of the study subjects were (20-24) years on the same subject, this differences may be due to that most women marry early age, early marriage is one of the reasons and proper reproductive age in Al-Hilla city (9) .Regarding to the residency majority of the study sample (60.9%) were urban area, this result is supported by previous study in Erbil governorate, Iraq (2014) in their result indicated that most of participants were urban area(75.9%) (10).This can be explained by the study sample included sector health and most of them inhabited urban and these services are widely distributed primarily in urban areas and are easily accessible.Concerning occupational status, the findings of the present study reveal that most of studied subjects (85.9%) were housewife, this result issupported byEgyptian study related to women's satisfaction and perception of antenatal care it showedthat in their result that ( 95.1 %) were housewives (11) .Regarding educational levels the majority of sample (43.6%) were primary educational, this result is supported by another study which agree with the present study (12) .The study shows that majority of the study sample (40%) were less 300.000 dinars monthly income, this result is coincide to was (32.9%) less than 500.000dinars monthly income, this agreement of both studies are reasons living conditions prevailing in the country and living below the poverty line with low monthly income of Iraqi family (13) .The findings of the study indicate that majority of the studies number of previous pregnancy had (34.5%) one gravida, that result is supported present result indicated that majority of this subjects (42.3 %) were one gravida.The results showed that the ideal period for women between the ages of (21-25) years, early marriage (14) .Regarding to the duration of pregnancy the findings of the present study show that majority of the study sample (42.7%) were second trimester, Another studyindicated that majority of this subjects (67.8%) were second trimester.It is considered critical for pregnant stages of embryo formation pregnant need special attention to nutrition and health status monitor and follow up the schedule tetanus vaccine and prevent anemia (15) .Another result indicates the majority pregnant women's haven't abortion of the study sample (75.5%) don't have abortion, this result is supported by another study (72.4%) this result indicated that most of pregnancies were without abortion.The reason for this result of promoting antenatal check-ups and associated counseling in general and the study showed that the first and second trimester of pregnancy are the highest in the study sample (16) .
Concerning pregnant women's complication, the findings of the present study show that majority of the study sample (70.5%) were no complication, this result is supported by study in South of Africa 2014, was (72%) this result agree with the result of present study indicated that most of pregnancies were without complications.The reason for this result were in first or second gravid and reduce complications during visits regularly get knowledge, awareness and health education pregnancy without complications (17) .Regarding Care Services among Pregnant Women's in Al-Hilla City ‫الحلت‬ ‫مذينت‬ ‫في‬ ‫الحوامل‬ ‫النساء‬ ‫بين‬ ‫الوالدة‬ ‫قبل‬ ‫الرعايت‬ ‫خذماث‬ ‫تقييم‬ Ali F. Abdul Hussein, M.S. College of Nursing / University of Babylon.Ameen A. Yaser, A. Prof., College of Nursing / University of Babylon.

Table 1 : Distribution of Pregnant Women's by Demographic Data. F. Frequency %. Percentage Table
1show that the highest percentage of pregnant women's were age (36.8%) (20-24) years old;

Table 3
showthat the study subjects are fair with overall antenatal care services at provide primary health care centers.