Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 143 Volume 2 Issue 2 June (2022) DOI: 10.47540/ijias.v2i2.484 Page: 143 – 149 Role of Mass Media in Using Antenatal Care Services among Pregnant Women in Bangladesh Rawnaq Ara Parvin1, Md. Faisal-E-Alam2*, Md. Belal Hossain3 1Department of Sociology, Varendra University, Bangladesh 2Department of Management Studies, Begum Rokeya University, Bangladesh 3Department of Mass Communication and Journalism, Comilla University, Bangladesh Corresponding Author: Md. Faisal-E-Alam; Email: faisal14.ru@gmail.com A R T I C L E I N F O A B S T R A C T Keywords: Antenatal Care Services, Mass Media, Pregnant Women. Received : 27 March 2022 Revised : 29 May 2022 Accepted : 01 June 2022 The purpose of this study is to measure the predicting factors which can play a role of mass media in using the Antenatal Care Services (ANC) for pregnant women. The mixed-method strategy is followed in this study. 50 women were selected based on a convenient sampling technique to gather survey data including open and closed-ended responses. A frequency table was carried out to generate the study findings. Along with this, a few case studies were taken to support the quantitative findings so that the outcomes proved a more solid investigation. The study findings showed that there was a positive linkage between media programs and the ANC status of rural women. Pregnant women will get a clear view of how they should be more aware when they are in complications and how they will take advice from mass media pre-post delivery period. INTRODUCTION In 2017, globally about 2,95,000 women died from maternal complicacy (WHO, 2019a). In Sub- Saharan Africa and South Asia within low resource settings, roughly 87 percent of preventable maternal fatalities occur (Crowe et al., 2012; WHO, 2019b). The maternal mortality rate in Bangladesh (173.00 per 100,000 live births), declined by 6.99% in 2016 (Macrotrends, 2021). Knowledgeable and timely antenatal care check-ups and delivery are pathways to reducing maternal mortality and morbidity, as well as newborn fatalities (Munguambe et al., 2016; Jackson et al., 2017). ANC's goals are to screen for and improve maternal and fetal health, as well as to undertake medical and social interventions to ensure safe pregnancy and delivery (McDonagh, 1996). Coverage of access to ANC services through a healthcare center or from skilled health providers (Talukder et al., 2021), can prevent and lower the odds of maternal mortality with the collaboration of skilled birth attendance (Acharya et al., 2021). Disappointingly, Just 21% of pregnant women in Bangladesh receive the 4 times optimal ANC visits, despite rising rates of overall ANC use in maternal health care over the last decades (El Arifeenet al., 2013). ANC services bring benefits during pregnancy and childbirth by facilitating greater use of emergency obstetric care services. To scale up ANC attendance and raise awareness from individual to the community level, media plays a profound role in disseminating health education and information (Dhawanet al., 2020; Gebremeskelet al., 2015). ANC is defined as four or more prenatal visits, at least one tetanus toxoid (TT) injection, and confirmed iron-folic acid (IFA) medicine intake consumption by the mothers (IIPS, 2017). In Bangladesh, there are minimal studies on the factors that predict the role of the media in a mother’s ANC. While most previous research has examined healthcare utilization and gestation effects using quantitative data. None of these studies conducted in Bangladesh provide any evidence on the factors predicting mass media's role in women’s ANC. Huda et al. (2019) recently published a study on Individual and community- level factors associated with health facility delivery; INDONESIAN JOURNAL OF INNOVATION AND APPLIED SCIENCES (IJIAS) Journal Homepage: https://ojs.literacyinstitute.org/index.php/ijias ISSN: 2775-4162 (Online) Research Article https://ojs.literacyinstitute.org/index.php/ijias http://issn.pdii.lipi.go.id/issn.cgi?daftar&1587190067&1&&2020 Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 144 however, they did not evaluate the possible effect of mass media on ANC use, as did previous studies. A survey report (BDHS) 2017-2018 showed that 82% of women received at least one ANC visit from a medical provider (BDHS, 2019). However, just seven (20%) of the 36 women received their first ANC visit within 12 weeks of gestational age (Jo et al., 2019). With 173 deaths per 100,000 live births, Bangladesh has made significant progress toward the Millennium Development Goal (MDG). Saturation of the media is effective at raising awareness and knowledge promoting interpersonal contact of obstetric care. Thus, research that addresses mass media's role in women’s ANC status is seen as essential. The present study would help the role of mass media in the utilization of Antenatal Care Services of pregnant women of Shashidal Union under Brahmanpara Upazila, Comilla district in Bangladesh, and would also identify the important factors related to antenatal care services of pregnant women. METHODS Research design The present work is based on explorative research using a mixed-method (Timans et al., 2019) approach involving a questionnaire survey and two interviews took to examine and analyze the role of mass media on the utilization of Antenatal Care Services among pregnant women in selected ten villages in the rural areas of Shashidal Union of Brahmanpara Upazilla under Cumilla district in Bangladesh. The survey was conducted among pregnant women between the reproductive ages of 18 years and above, who utilized the ANC services started in November 2018 and ended in March 2019. However, to gain and assess an actual scenario of the media influences on utilizing ANC services, the research utilized the help of four research assistants. Being a firsthand explorative study the respondents were conveniently chosen by convenience sampling technique following the Non- Probability sampling method from selected ten villages in the rural areas of Shashidal Union of Brahmanpara Upazilla under Cumilla district in Bangladesh, six qualitative case studies were collected from Anandapur, Deus, South Bagra, Shibpur, East Bagra, Shashidal. Study population Pregnant women from the Shashidal Union of Brahmaputra Upazila under Comilla district in Bangladesh were the study population for this study. This Upazila is a conventional rural area of Bangladesh. The convenience Sample Technique is used to select ten villages that have been selected. Because there is psychical proximity and cooperation from the union. Moreover, a convenient sample of 50 participants has been interviewed from each village due to the unknown population. The distribution of respondents has been taken as follows: Table 1. Information of the Villages and Respondents SL Name of Village No. of Participants Unit of Analysis 01 Anandapur 05 The pregnant women who were aged 18 years and above residing in the researched areas have given consent for information collection for interviewed through questionnaire. 02 Deus 05 03 South Bagra 05 04 Shibpur 05 05 East Bagra 05 06 Shashidal 05 07 Begumabad 05 08 Manora 05 09 Tetabhumi 05 10 Ramchandrapur 05 Grand Total 50 The rationale for selecting, these villages are based on the fact that the majority of pregnant women from the respective villages take Antenatal Care Services (ANC) from the health institutions. This study sample has consisted of 50 pregnant women. Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 145 Data collection This research used an exploratory survey design in which both qualitative and quantitative aspects of assessing the socio-demographic status and exploring predisposing factors of receiving ANC services of pregnant women through the lens of media influences were investigated. At first, the study collected primary data from respondents using a structured interview schedule, including both closed-ended and open-ended questions to collect the required information about their socio- demographic status and predisposing factors. To get detailed information about the research questions and the interview guide required in this research, two cases were collected by using a case study method during the survey. Data analysis Collected information was processed and compiled with the aid of Excel MS and MS Word. Necessary tables were prepared based on collected data. Detailed explanation and analysis have been incorporated in the paper. Then the findings have been made as well. Based on the findings, the present situation has been explained and recommendation has also been made. RESULTS AND DISCUSSION A total of 50 pregnant women participated in this study, the age range is between 16 and 35 years, only Shashidol Union was the exception starting with above eighteen years of age. The lowest age range exists between 31 to 35 which is 14 percent. The Second lowest percentage is 14 and found in the age range sixteen to twenty and were above 18 years. A total of 24% is from 26-to 30. The representative number is 44% which belongs to the age of 21 to 25. All of them are Muslim communities. Table 2. Age Range Age Frequency Percentage (%) 16-20 9 18 21-25 22 44 26-30 12 24 31-35 7 14 Source: Field Level Survey, 2019 Total respondents are rural population. All participants were literate, but only 8% of them are not formally educated. Among them, 16% were completed 8 grades. 28% completed secondary school, and 36% is the remarkable one who has completed higher secondary education. All women were married and 96% of them had children, only 4% of respondents were going to give birth for the first time. In terms of occupation, 2 participants were journalists and 7 are teachers. While the largest rest of the 41 women were housewives. Table 3. Information about monthly income of the respondents’ Family Monthly Income of Family (In thousand) Frequency Percentage (%) 0-20 23 46 20-40 14 28 40-60 8 16 60-80 2 4 80-100 2 4 100-120 1 2 Source: Field Level Survey, 2019 The highest number of the respondent’s husbands is working in national and multinational companies, it was under twenty thousand and about 46%. 28% of respondents’ family income was under forty thousand. 16% of respondents’ family income was in the range of forty to sixty and 4% was in sixty thousand to eighty thousand and 4% was in eighty thousand to one lakh. Only 2% of these respondents’ family income is above one lakh. Among these fifty respondents, there are huge variations in the husband’s occupation. Cobbler, doctor, day labor, police, social worker, and minister are separately 2%. Only 8% of respondents’ husbands are teachers and 28% are businessmen. Respondents’ concepts about mass media With the rapid socio-economical forces of change, mass media has reached the remotest area like Shashidol Union. Most of the respondents used mass media for information or recreation purposes. Among these 50 participants of the Shashidol Union, only 4% had no idea about mass media, and the grand 96% poses perceptions about mass media. Commonly, they had not enough time for roaming, moreover using the internet is not well accepted in rural areas as there is a chance of interacting with strangers. They use newspapers, radio, and television as mass media. Most of the respondents watch television, which is about 68%. Only 4% listen to the radio, 10% are readers of Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 146 the newspaper, and 10% have all kinds of mass media contacts including Facebook. Mass media usage on a regularity basis Almost all respondents stated that they are using mass media, which is about 94%. Only 6% are not using mass media regularly. They opined it quite expensive and they had not been offered with personal mobile usage and internet web. As two women observed: “Our family members always find it contradictory and valueless with our housework, no matter how long we spent time on these”. Barriers to getting connected with mass media Most of the respondents expressed barriers to getting antenatal healthcare-related information for household pressure, which is about 30%. The second-highest number of respondents informed of the unavailability of mass media is about 28%. 18% described family pressure as a barrier and for not being techno-friendly is 8%. Only 14% of respondents illustrated other barriers. Table 4. Types of Barriers faced by the Respondent Types of Barriers faced by the Respondent Category Frequency Percentage Family Pressure 9 18.0 Household Pressure 15 30.0 Lack of technological knowledge 4 8.0 Other's Problem 7 14.0 Unavailability of Mass Media 14 28.0 Total 50 100.0 Source: Field Level Survey, 2019 Preferred media during pregnancies for getting information During the pregnancy period, 4% of respondents stated that they prefer Facebook for getting information about antenatal care, 6% newspaper, 8% radio, 58% prefer television and 24% prefer every type of mass media. Participants claimed that Facebook for getting antenatal health care information is the oddest practice but the television is a source of knowledge they believe. Graph 1. Preferred media during pregnancies for getting information Mass media benefaction from awareness-raising campaigns during the pregnancy period Different health-related programs stemming from mass media helped pregnant women, information related to tad’s health or mother’s health or antenatal care provided knowledge, as the respondents informed. 22% of respondents of Shashidol Union expressed about getting maternal health care, 6% got about tad’s health and 24% got about antenatal care. Most of the respondents believed they got several types of pregnancy-related information. Table 5. Types of information from mass media Types of information from social media Frequency Percentage All 24 48% Antenatal care 12 24% Mother’s health 11 22% Tad’s health 3 6% Source: Field Level Survey, 2019 Television Radio Newspaper & Facebook All Types Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 147 Respondents’ knowledge of Antenatal Care Most of the respondents had been observed owing average knowledge of antenatal care, which is about 40%. Among them, 34% have basic knowledge about antenatal care, and 18% have proper and only 8% have dim knowledge. Table 6. Knowledge regarding ANC ANC Knowledge Frequency Percentage Average 20 40% Few 4 8% Good 17 34% Very Good 9 18% Source: Field Level Survey, 2019 Most participants watched the program named Swasthya Barta (health message) to get antenatal health-related information, it is about 52%. Among them, 18% watched drama for getting information about antenatal care, 26% used health-related documents, and 2% used other programs. ANC Visits Each respondent had been to a doctor during her pregnancy time. 14% of respondents went to the doctor only one time, 46% for three times, 24% for four times, 16% for five times. Discussions Several studies in Bangladesh have investigated the impact of socioeconomic, demographic, and anthropometric (BMI) characteristics on antenatal care for Bangladeshi pregnant women. The focus of this study was to study pregnant women's experiences and perspectives on the role of mass media in antenatal care utilization in Shashidal Union, Bangladesh, while also confirming that mass media use is low in this socioeconomic and cultural milieu. The authors recognize that convenience sampling is susceptible to sampling bias, resulting in a homogeneous sample that could skew the results of the study (Hedt & Pagano, 2011). However, steps have been attempted to reduce this disadvantage. Furthermore, while thematic analysis is adaptable, this adaptability can lead to inconsistencies in the development of themes. The study's claims were supported by rational choice theories, which fostered consistency (Owumi, B. E, 2013). In this study, most of the mass media users are higher secondary graduates, and their ages are between 21 to 25 years old. Both educated and lower-educated women had benefited from different mass media outlets in receiving ANC. Research showed that audiences with hardly formal education find mass media to be quite acceptable and helpful, Mosa et al, and Kamal found similar outcomes. Television is still an important source of receiving health and educational information. A variety of health-related television programs enriched their level of knowledge. In addition, there are some barriers to getting ANC-related information through mass media, workload and child care are common to them (Rahman et al., 2016). But, Prices (including transport and time cost of getting healthcare), income, a lack of knowledge about suitable treatment and sources, patient complications, and perceived severity all influence patient choice (Uzochukwu et al., 2009). Pregnant women's key sources of information on Antenatal Care Services (ANC), their media preferences for ANC programs, their suitable timing, and the problems they confront in using the mass media in rural Bangladesh are explored in this study. The study was carried out in a few selected villages to examine media awareness, use, and knowledge in the use of antenatal health care services by pregnant women. This study was carried out to determine how frequently pregnant women attend ANC to have a healthy pregnancy. The current study discovered a link between pregnant women's ANC status and their ability to access media programs. They are more concerned about their own health as well as the health and well-being of their children. They have a clear grasp of the complications that may arise throughout their pregnancy, delivery, and/or post-partum period. A study conducted in Bangladesh revealed comparable results, confirming our findings (Amin, 2010). Furthermore, Parvin et al. (2022) also showed that utilizing maternal health care services by pregnant mothers is justified through practical difficulties and perceptions regarding service availability. Our study found that pregnant mothers usually reconcile seemingly opposing ideas about bad fortune and the dread of financial loss, and accept everything as fate. That even increases and decreases the number of ANC visits. This response resembles Karl Marx’s connection between poverty and illness (Collyer, 2015). Indonesian Journal of Innovation and Applied Sciences (IJIAS), 2 (2), 143-149 148 The following recommendations are made based on the findings of this study to improve the role of mass media in the utilization of antenatal care services among pregnant women in the studied locations. The following are some suggestions: 1. Husbands should be more responsive to their wives about antenatal care; 2. Information about antenatal care should be available through the media; 3. Government and other concerned authorities should take necessary steps to ensure proper antenatal care services; 4. Doctors, nurses, and other health workers should provide proper services to pregnant women and related necessary ideas about ANC. CONCLUSION In this study, 24% percent of mothers had four rounds of visits to ANC, whereas a remarkable number of pregnant women 14% sought ANC services once. 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