the prevalence of preterm delivery and to assess the knowledge and practice of women on the prevention of premature delivery

CHAPTER ONE

INTRODUCTION

1.0 Background

The World Health Organization (WHO) defines premature delivery (PTD) as any birth before 37 completed weeks of gestation or fewer than 259 days since the first day of the woman’s last menstrual period (FNMP) [1, 4]. Since premature delivery is a major problem worldwide, it has drawn attention and since 2011, the 17^th of November is being commemorated as the Premature Delivery Day. Preterm birth can be divided into sub categories based on the gestational age. As suggested by the National Institute of Child Health and Human Development of the National Institute of Health (NIH) in the USA, PTD can be classified as;  extreme preterm(<28weeks), very  preterm( 28-32 weeks) and moderate to Late preterm (32-36 weeks).

Developing countries have a higher occurrence of premature delivery.  Also, premature babies will drastically die depending on where they are born whether in developed or developing countries. Extremely premature babies; less than 28 weeks can survive in developed countries but in developing countries such as Cameroon less than 28 week is said to be an abortion and will likely not survive [4]. Newborns in developing countries have a morbidity of 90% [4]. The rate of premature delivery is increasing worldwide, including Cameroon. 15 million newborns globally are delivered preterm each year and a million of them would die. Preterm delivery is also a very challenging Obstetric complication in which early identification of risk factors may help women at risk thus lowering the incidence of preterm deliveries [1, 5].

The main causes of premature delivery are still unknown in over 50% of spontaneous preterm labour while the mechanism of premature labour still remains poorly understood. Hence, identifying and understanding risk factors of premature delivery would have potentials to help address this problem [6]. Preterm births have the following risk factors; hypertensive disorders, anemia, urethral tract infection, maternal age, and multiple pregnancies [6].

Significant progress has been made in the care of preterm infants or neonates but not in reducing the prevalence of premature delivery which is generally rising. Premature delivery constitutes a significant public health challenge because of the high level of morbidity and mortality and long term health effects associated with it. These problems could be short and/or long-term complications for the newborns that will initially survive. It is a major health problem and manifests as a pathological outcome of pregnancy [1].  Extreme premature deliveries in developing countries usually result in death reason why it is considered as abortion while more tend to survive in developed countries [3]. Three-quarters of these deaths could be prevented with current, cost-effective interventions. Since prematurity is a major problem, neonates who are preterm are of greater risk of neonatal morbidity, mortality and will turn to have a variety of health developmental problems [1].

1.1 PROBLEM STATEMENT

Even though some health facilities have been provided with medical equipment for the management of premature delivery, many premature delivery cases still occur especially because of lack of knowledge on the risk factors associated with it by women. The care required for the survival of a premature baby ranges from 600,000 CFA francs to 1,000,000 CFA francs according to the Ministry of Public Health and this sum is not within the reach of an average Cameroon [27]. Thus the cost of caring for premature babies therefore remains high in Cameroon. Therefore, this study seeks to find out the prevalence, to asses knowledge and practice of women in the prevention of premature delivery in the Buea Health District.

1.2 JUSTIFICATION

Preterm delivery remains a global health burden especially in low and middle income countries like Cameroon. In Cameroon, about 90,000 babies are born annually with a weight of less than 2,500g and before 37 weeks. Of these, nearly 10,000 die of preventable causes and this prematurity is the second leading cause of death before the age of five [27]. Therefore, this research would evaluate the level of awareness and knowledge of women in the Buea Health District on the risk factors associated with premature delivery. It will also highlight the practices towards the preventive measures by the women. This information would be valuable in reducing the high incidence of PTD.

1.3 RESEARCH GOAL

The goal of this study was to determine burden of premature delivery in the Buea Health District and to evaluate the knowledge of women in Buea on the factors that are associated to premature delivery.

1.4 RESEARCH OBJECTIVE

1.4.1 GENERAL OBJECTIVE

To determine the prevalence of preterm delivery and to assess the knowledge and practice of women on the prevention of premature delivery.

1.4.2 SPECIFIC OBJECTIVES

• To determine the prevalence of premature delivery in the Buea Health District

• To assess the knowledge of women on the risk factors of premature delivery.

• To assess practice of women towards the prevention of premature delivery.

1.5 RESEARCH QUESTIONS

• What is the prevalence of premature delivery in the Buea Health District?
• Are women of the Buea Health District knowledgeable about the risk factors that are associated with premature delivery.
• What are the practices of women of the Buea Health District toward the preventive of premature delivery?

NURSING PROJECT TOPICS WITH MATERIALS