ANTENATAL CARE SITUATION AND FACTORS INFLUENCING SELF-CARE BEHAVIORS AMONG PREGNANT WOMEN ATTENDING PRIMARY CARE UNITS IN MAKHA, MUEANG DISTRICT, NAKHON RATCHASIMA PROVINCE
Keywords:
Prenatal care, Self-care behavior, Primary health care system, Health services accessibility, Maternal health servicesAbstract
Abstract
This mixed-methods research aimed to explore the situation, problems, obstacles, and factors influencing self-care behaviors among pregnant women receiving services at primary health care units. Key informants included 12 antenatal care (ANC) service providers. The sample group consisted of 91 pregnant women selected through simple random sampling. Data collection tools included pregnancy record forms, interview guidelines, and questionnaires. The content validity of the instruments was assessed by experts, and the reliability coefficients of the reliability for questionnaires ranged from 0.77 to 0.88. Qualitative data were analyzed using content analysis and inductive summarization, while quantitative data were analyzed using descriptive statistics (percentage, mean, and standard deviation) and inferential statistics, including Pearson’s correlation coefficient and multiple regression analysis using the stepwise regression method.
Findings revealed that the average age of first-time pregnant women was 25.68 years. Most were in non-registered partnerships (60.8%) and used the universal healthcare scheme (78.5%). About 64.0% received antenatal care (ANC) before 12 weeks of gestation, with a mean gestational age of 11.8 weeks. However, 62.0% did not complete the recommended five ANC visits. Laboratory results showed 98.7% had no infections (HBsAg, VDRL, HIV), and 90.0% had normal hemoglobin and hematocrit levels, while 1.3% were thalassemia carriers. The ANC services were implemented in accordance with national standards and supported by village health volunteers. However, the system faced limitations in infrastructure, equipment, and specialized personnel. Two key factors significantly predicting self-care behaviors (p < 0.05) were accessibility to antenatal care services and policies promoting maternal health, together accounting for 50.6% of the variance (R² = 0.506).
Conclusion: Although early ANC initiation met national standards, the rate of incomplete ANC visits was high. Strengthening health infrastructure, providing targeted training for personnel, and enhancing policy implementation could improve service quality and maternal self-care behavior.
Keywords: Prenatal care, Self-care behavior, Primary health care system, Health services accessibility, Maternal health services
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