COLLEGE OF HEALTH SCIENCE

DEPARTMENT OF MIDWIFERY

ASSESSMENT OF KNOWLEDGE AND ATTITUDE TOWARDS

PHYSICAL ACTIVITY DURING PREGNANCY AND ITS
ASSOCIATED FACTOR AMONG WOMEN ATTENDING
ANTENATAL CARE AT PUBLIC HEALTH INSTITUTION OF
AKAKI KALITY SUB CITY ADDIS ABEBA, ETHIOPIA, 2019.

PI (Amanuel Gashaw, Israel Diress, Mistre Gossa, and Hewan G/medihn)

Thesis Report Submitted to community-based education, Debre Berhan University, College of

Health Science, for Partial Fulfillment of Bachelors Science Degree for Midwifery.

June, 2019

Debre Berhan, Ethiopia

I
Debre Berhan University, Institute of medicine and health science,
college of health science department of midwifery

Title Assessment of knowledge and attitude towards physical activity during

pregnancy and its associated factor among pregnant women attending
antenatal care at public health institutions in Akaki-Kality sub city Addis
Ababa, Ethiopia, 2019.

Investigators Mistre Gossa, Israel Diress, Amanuel Gashaw, and Hewan G/Medihn

Advisor Solomon Adinew

Study period February 15 to March 15, 2019

Contact Cell phone: 0946158959

Address of
Email: amanueldbumid@gmail.com
Team Leader

II
 Debre Berhan University

College of health sciences

Department of Midwifery

Advisor’s and Examiner’s Approval Sheet

This is to certify that the thesis report entitled “assessment of knowledge and attitude towards
physical activity during pregnancy and its associated factor among pregnant women attending
antenatal care at public health institution in Akaki-Kality sub city Addis Ababa, Ethiopia, 2019 is
submitted in partial fulfillment of the requirements for the Bachelor science degree in midwifery
to the Graduate Program of the College of health sciences of Debre Berhan University and has
been carried out by Mistre Gossa, Israel Dires, Amanuel Gashaw and Hewan G/Medihn under
my supervision. Therefore, I recommend that the students have fulfilled the requirements and
hence hereby can submit the research proposal to the Department.

Name of Advisor Signature Date

Name of Examiner Signature Date

III
Acknowledgment
First, we would thank our advisors Mr. Solomon Adinew (MSc) his valuable support for the
preparation of this proposal.

Our deepest appreciation goes to Debre Berhan University, department of midwifery for
providing the opportunity to develop this research proposal.

We would like to extend our deepest thanks for Akaki-Kality sub city administrative office for
their cooperation and giving valuable data.

We would like to thank for all Akaki-Kality sub city health center staff workers for their
cooperation and giving valuable data.

1
 Table of Contents

Acknowledgment..............................................................................................................................I
Table of Contents............................................................................................................................II

List of tables..................................................................................................................................III

List of figures................................................................................................................................IV

List of Acronyms and Abbreviations..............................................................................................V

Summary........................................................................................................................................VI

Chapter One: Introduction...............................................................................................................1

1.1 Background.......................................................................................................................1

1.2 Statement of the problem..................................................................................................3

1.3 Significance of the study...................................................................................................5

Chapter Two: Literature Review.....................................................................................................6

2.1Knowledge and attitude towards antenatal physical activity..................................................6

2.2 Factors associated with knowledge and attitude towards physical activity among pregnant
women..........................................................................................................................................8

2.3 Conceptual Frame Work......................................................................................................10

Chapter Three: Objective of the Study......................................................................................11

3.1 General objective.................................................................................................................11

3.2. Specific objective................................................................................................................11

Chapter Four: Methods and Materials...........................................................................................12

4.1. Study area and period..........................................................................................................12

4.2. Study design........................................................................................................................12

4.3. Source of population and study population and participant................................................12

4.3.1 Source population..........................................................................................................12

4.3.2. Study population...........................................................................................................12

2
 4.3.3. Study participant...........................................................................................................12

4.4. Eligible Criteria...............................................................................................................12

4.4.1. Inclusion criteria...........................................................................................................12

4.4.2. Exclusion criteria..........................................................................................................12

4.5 Sample size determination................................................................................................13

4.6. Sampling technique and procedure.....................................................................................13

4.7. Study variable.....................................................................................................................15

4.7.1 Dependent variable........................................................................................................15

4.7.2 Independent variables....................................................................................................15

4.8. Operational definition.........................................................................................................15

4.9 Data collection instrument and procedure...........................................................................16

4.10 Data quality assurance.......................................................................................................16

4.11 Data processing and analysis.............................................................................................16

4.12 Dissemination of results.....................................................................................................16

4.13 Ethical consideration..........................................................................................................16

5. Work plan and budget break down............................................................................................18

5.1 Work Plan............................................................................................................................18

5.2 Budget break down..................................................................................................................19

6. References..................................................................................................................................20

7. Annexes.....................................................................................................................................23

Annex Ⅰ: Information sheet............................................................................................................23

Annex Ⅱ: Consent Form............................................................................................................24

Annex Ⅲ: English Questionnaire..............................................................................................25

Annex2: Amharic questionnaire................................................................................................31

3
List of tables
Table 1: Work plan to assess knowledge and attitude towards physical activity during pregnancy
and its associated factors for pregnant women attending antenatal care at public health
institutions in Akaki-Kality sub city, Addis Ababa, Ethiopia, 2019.............................................18
Table 2: Budget break down to assess knowledge and attitude towards physical activity during
pregnancy and its associated factors for pregnant women attending antenatal care at public health
institutions in Akaki-Kality sub city, Addis Ababa, Ethiopia, 2019.............................................19

4
 List of figures
Figure 1: Conceptual framework of knowledge and attitude towards physical activity during
pregnancy and its associated factors for pregnant women attending antenatal care at public health
institutions in Akaki-Kality sub city, Addis Ababa, Ethiopia, 2019.............................................10
Figure 2: Schematic presentation of the sampling procedure........................................................14

5
 List of Acronyms and Abbreviations
ACOG--- American College of Obstetricians and Gynecologists

ANC --- Antenatal Care

ANEx---- Antenatal Exercise

CI----Confidence Interval

DBU--- Debre Berhan University

DVT --- Deep Venous Thrombosis

ECSA----Ethiopia Central Statistical Authority

EGWG --- Excessive Gestational Weight Gain

ETB --- Ethiopian Birr

GDM-- Gestational Diabetic Mellitus

KAP--- Knowledge Attitude and Practice

MMR --- Maternal Mortality Ratio

MOH--- Ministry Of Health

PA --- Physical Activity

PI ---principal investigators

PIH --- Pregnancy Induced Hypertension

SPSS--- Statistical Package for Social Science

WKs --- Weeks

6
Abstract
Introduction: Physical activity, defined as any bodily movement produced by the contraction of
skeletal muscles in all stages of life maintains and improves cardio respiratory fitness, reduces
the risk of obesity and associated comorbidities, and results in greater longevity. Exercise,
defined as activity consisting of planned, structured, and repetitive bodily movement. Physical
inactivity is the fourth-leading risk factor for early mortality worldwide. Physical inactivity
during pregnancy is associated with serious short- and long-term risks for mothers and babies.

Objective: The study aimed to assess knowledge and attitude towards antenatal physical activity
and its associated factor among pregnant women attending antenatal care at public health
institutions in Akaki-Kality sub city, Addis Ababa, Ethiopia 2019.

Methods and Materials: An institutional-based cross-sectional study design was employed and
399 participants were invited to this study. The participants were selected through systematic
random sampling technique. This study was conducted from February 15 to march 15. The data
was collected through a structured questionnaire and face to face interview and the analysis was
performed through SSPS 20 and Epi info 7 computer program. Result

7
 Chapter One: Introduction
1.1 Background
Physical activity (PA), defined as any bodily movement produced by the contraction of skeletal
muscles in all stages of life maintains and improves cardio respiratory fitness, reduces the risk of
obesity and associated co morbidities, and results in greater longevity. Exercise, defined as
activity consisting of planned, structured, and repetitive bodily movements done to improve one
or more components of physical fitness, is an essential element of a healthy lifestyle(1).
Generally, exercise is a subset of physical activity, so physical activity includes exercises and
any day to day activities(2).

Being in sedentary activity lifestyles increase the risk of antenatal and postnatal depression.
Reductions in physical activity and a worsening mood are common during pregnancy. If the
relationship between physical inactivity and mood disturbances is indeed observed and
maintained during pregnancy, then decreases in physical activity in the third trimester would be
expected to result in a worsening mood(3).

According to the American college of Obstetricians and Gynecologists (ACOG), Walking,

Swimming, Stationary cycling, Low-impact aerobics, yoga modified, Pilates modified and
racquet sports recommended for women with uncomplicated pregnancies. Racquet sports
wherein a pregnant woman’s changing balance may affect rapid movements and increase the risk
of falling should be avoided as much as possible. Yoga modified positions that result in
decreased venous return and hypotension should be avoided as much as possible, whereas
contact sports (e.g., ice hockey, boxing, soccer, and basketball) and activities with a high risk of
falling (e.g., downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and
horseback riding), activities performed above 6,000 feet(if do not already leave at a high
altitude), scuba diving, sky diving and hot yoga or hot Pilates (which may cause to become
overheated)(1)(4).

Physical activity during pregnancy is important for the health of the mother and the child and
may reduce the risk of adverse maternal, fetal and neonatal outcomes(5).

Based on different literatures, the knowledge and attitude of pregnant women towards physical
activity shown that maximum of the pregnant women had poor knowledge (65.35%)and neutral

8
attitude (44.55%) with regard to physical activity during pregnancy(6). In Africa, pregnant
women towards physical activity had poor knowledge (47.6%)(7). Women in low-income
counties are generally considered to have a high physical workload which is sustained during
pregnancy and may contribute to the high incidence of low birth weight. However, there only a
few published studies on physical activity among pregnant women in low-income countries(8).
In Ethiopia study result showed in Kirkos sub-city Addis Ababa, the majority of pregnant
women had not knowledge and more than half had a positive attitude about antenatal physical
activity(9). So, it is very important to create awareness and positive attitude towards physical
activity among pregnant mothers and its benefits and contraindications.

This study was conducted to provide evidence and source of information on the assessment of
knowledge and attitude of physical activity during pregnancy and its associated factor in the
study area.

9
 1.2 Statement of the problem
Pregnancy is a time in women lives that are associated with considerable physiological and
psychological changes which may promote sedentary behaviors and/or low levels of physical
activity. such behaviors have been associated with elevated risk of gestational diabetes mellitus
(GDM), pregnancy-induced hypertension (PIH), high gestational weight gain and cardiovascular
disease, preterm birth, varicose vein, and deep vein thrombosis (DVT)(10)(11). Physical
inactivity is the fourth leading risk factor of early mortality worldwide(1). Physical inactivity
during pregnancy is associated with serious short- and long-term risks for mothers and babies(3).
Regular physical exercise appears to lower the risk of GDM, preeclampsia, and reduce excessive
gestational weight gain (EGWG) which is an important predictor of numerous adverse maternal
outcomes(12). Evidence suggests that preterm birth and gestational hypertension risk may be
altered by regular leisure-time physical activity. The potential hypothesis for such a mechanism
is based on a reduction in blood pressure, improvement in blood lipids profile, reduction in blood
oxidative stress and inflammation reduction(13).

Every day, approximately 830 women die from preventable causes related to pregnancy and
childbirth. 99% of all deaths occur in developing countries. The maternal mortality ratio (MMR)
in developing countries in 2015 is 239 per 100,000 live births vs 12 per 100,000 live birth in
developed countries(14). Excessive gestational weight gain is associated with the development of
maternal hypertension and preeclampsia. Globally, approximately 10% of all pregnancies are
complicated by hypertension, which is a major cause of both fetal and maternal morbidity and
mortality. PA has been shown to be an important factor which helps to improve pregnancy
outcomes(15). And also, the importance of guided antenatal exercises (ANEx) during pregnancy
should be stressed as these provide safe motherhood and improve neonatal outcomes(16).

There is a dearth of information regarding women’s attitudes toward physical activity in

pregnancy. A small number of studies have highlighted significant barriers to participation,
including lack of time, lack of facilities, and physical barriers. Indeed, it has been found that
some women perceive physical activity to been unsafe behavior when pregnant. However, few
studies have offered detailed insights into the views and experiences of overweight and obese
women themselves(17).

10
A study conducted in Africa, Nigeria, showed that 47.6% had poor knowledge(7). Women in
low-income counties are generally considered to have a high physical workload which is
sustained during pregnancy and may contribute to the high incidence of low birth weight.
However, there only a few published studies on physical activity among pregnant women in low-
income countries(8).

In Ethiopia study result showed in Kirkos sub-city Addis Ababa, the majority of pregnant
women had not knowledge and more than half had a positive attitude about ANEx(9).

In our country Ethiopia, there is no more study, specifically in our study area Akaki-Kality sub
city there is no study about knowledge and attitude towards physical activity during pregnancy
among pregnant women. Therefore, this study was assessed knowledge and attitude towards
physical activity and its associated factors among pregnant women attending antenatal care
(ANC) at public health institutions in Akaki-Kality sub-city to produce baseline data for further
investigation and intervention based on the findings.

11
 1.3 Significance of the study
This study will help to identify important misconception of pregnant women towards activity
during pregnancy on the advantage for themselves and their fetus. It will address information
about factors associated with physical activity during pregnancy that are significantly barrier to
perform physical activity among mothers attending ANC. In addition, it will generate
information about knowledge and attitude of pregnant women towards physical activity during
pregnancy among pregnant women in a facility of attending antenatal care. The result that
obtained from this study may indicate as to making an emphasis on the possible interventions
depending on the study findings. Moreover, it can give insight and baseline data on to
policymakers (academic institution and ministry of health (MOH)), health care provider for
future planning and emphasizing or developing antenatal physical exercise guideline by
integrating into maternity health service. For the future researcher, this study will be an opening
door and or it gives baseline information.

12
Chapter Two: Literature Review
Physical activity provides many health benefits not only to pregnant mothers but also to the
fetuses. Adequate knowledge and positive attitude among pregnant mothers is vital to promote
practice(18).

2.1Knowledge and attitude towards antenatal physical activity

In 2011, a cross-sectional descriptive study on 161 pregnant women was conducted in Campinas,
Sao Paulo, Brazil on knowledge, attitude and practice of pregnant women with respect to
physical exercise during pregnancy showed that 65.6% of participants have adequate knowledge
about physical exercise and their attitude towards exercise was positive(19).

In 2018, a cross-ectional study conducted in the Eastern Province, Kingdom of Saudi Arabia on
knowledge and practice of physical activity among 388 pregnant women following in primary
health care centers, the result showed that the total mean knowledge score of the participants was
13.7±3.6. Of all participants, 69.5% had adequate knowledge(20).

A cross-sectional study conducted in India on the knowledge, attitude and practice of antenatal
exercise among 200 pregnant women showed that the total mean knowledge score was 20.53 ±
2.08. In this study, 51% felt it was necessary to do physical activity during pregnancy(21).

A cross-sectional study conducted in Mangalore, Karnataka, India on knowledge, perception and

attitude of pregnant women towards the role of physical therapy in ANC among 106 pregnant
women attending regular antenatal checkups that 46% of the subjects knew about ANEx. The
majority of them were not aware of the different type of ANEx. However, only 30% of the
participants had adequate knowledge of the benefits of ANEx(22).

Similarly, the study was conducted in India, Belgaum Karnataka on 101 pregnant women on
knowledge and attitude towards physical activity and the result shown that maximum of the
samples had poor knowledge (65.35%) and 34.65% had average knowledge with regard to
physical activity during pregnancy. The mean score of knowledge was 5.76 ± 2.35. Maximum of
samples were shown the positive attitude (55.44%) and neutral attitude (44.55%) with regard to
physical activity during pregnancy. The mean score of attitudes was 31.68± 3.65(6).

13
A prospective cohort study was conducted in China, Hong Kong on 534 pregnant women
towards the attitudes and knowledge of the subjects about exercise and pregnancy. In all, 120
(22.6%) claimed to have exercised regularly before pregnancy. Most (94.5%) agreed that
exercise was necessary during pregnancy. About half (51.5%) considered that pregnancy did not
affect their exercise routine but 11.7% believed it had been considerably limited. The main
reason for this limitation was reported to be fatigue (81.5%) followed by worry about fetal
growth (34.8%). In terms of the benefits of exercise during pregnancy, most thought that labor
may be shortened (85.6%) and general health of the mother or fetus would be improved (60.9%).
Most women obtained their information from the internet / website (48.3%), family / friends
(47.8%), and books (41.4%). Only a quarter (26.0%) obtained information from medical
staff(23).

In 2015, a cross-sectional study conducted in Colombo 110 among pregnant mothers attending
De Soyza Maternity Hospital Colombo on Knowledge, attitudes and practices regarding
antenatal exercises. The result showed that Knowledge regarding antenatal exercises was ‘poor’
among a majority (72.7%). Most had somewhat favorable (49.1%, n=54) and favorable (35.5%,
n=39) attitudes towards antenatal exercises(18).

The cross-sectional study recruited 189 Nigeria pregnant women from six selected hospitals on
knowledge and attitude towards antenatal exercise. The summative knowledge score revealed
that 47.6% of the respondents had below average knowledge and 5.82% had average knowledge,
while 46.6% had good knowledge of antenatal exercises. 15.8% of the respondents had a
negative attitude towards antenatal exercise resulting from insufficient information on exercise
(83.3%) and tiredness (70.0%). Relaxation and breathing (59.8%), back care (51.3%), and
muscle strengthening (51.3%) exercises were the most commonly known antenatal exercise.
Prevention of back pain risk (75.9%) and excess weight gain (69.1%) were perceived as benefits,
while lower extremities swelling (31.8%) and extreme weight gain or loss (30.7%) were
considered as contraindications to antenatal exercise(7).

In addition to this, a cross-sectional study conducted in Ethiopia, Addis Ababa, Kirkos sub
city355 pregnant women on attitude, knowledge and practice(KAP) towards antenatal exercise
among pregnant women and associated factors and about 56.6% pregnant women were not
knowledgeable and 52.1% had positive attitudes about antenatal exercise(9).

14
 2.2 Factors associated with knowledge and attitude towards physical activity among
pregnant women
A cross-sectional study conducted in the Eastern Province, Kingdom of Saudi Arabia on
knowledge and practice of physical activity among pregnant women following in primary health
care centers, the knowledge was affected by the education level(20).

Another study conducted in India, Belgaum, revealed that an association between the knowledge
with respect to physical activity during pregnancy and selected demographic variables, attitude
with respect to physical activity during pregnancy and selected demographic variables, any of the
demographic variables are not associated with knowledge and attitude with regard to physical
exercise during pregnancy among pregnant women. Only the age of the women is associated
with attitude with regard to physical exercise during pregnancy among pregnant women(6).
Similarly, the study conducted in India, Mangalore, Karnataka the result showed that the
knowledge of the participants was not influenced by maternal socio demographic
characteristics(22).

In 2015, a cross-sectional study conducted in Colombo 110 among pregnant mothers attending
De Soyza Maternity Hospital Colombo on Knowledge, attitudes and practices regarding
antenatal exercises. The result showed that doing a job during pregnancy was significantly
associated with possessing an excellent level of knowledge. While living in a district other than
Colombo was also associated significantly with an excellent level of knowledge. Average family
monthly income of > Rs. 25000 was associated with a level of ‘Favorable’ attitude(18).

A study conducted in Nigeria showed that 15.8% of the respondents had a negative attitude
towards antenatal exercise (ANEx) resulting from insufficient information on exercise (83.3%)
and tiredness (70.0%). Age significantly influences knowledge about contraindications to ANEx,
while attitude was influenced by age and occupation, respectively. There was a significant
association between attitude and knowledge about benefits and contraindications to ANEx. A
majority of Nigerian pregnant women demonstrated inadequate knowledge but had a positive
attitude towards ANEx. Knowledge about benefits and contraindications to ANEx significantly
influenced the attitude towards exercise in pregnancy(7).

15
And also, the study conducted in Kirkos sub-city, Addis Ababa showed that educational level of
a pregnant mother has to be a significant factor on respondent’s knowledge of ANEx. Those who
completed high school and college or university were found to be 3.55 and 2.85times more likely
to be knowledgeable about antenatal exercise than illiterate, respectively. In addition, income
level found as a significant factor on knowledge of ANEx, those who had ≥2000 income level
were 1.76 times more likely to be knowledgeable about antenatal exercise. Participating in
physical exercise before becoming pregnant had a significant association with knowledge of
ANEx. Respondents who had never practiced physical exercise before becoming pregnant were
70% times less likely to be knowledgeable than whoever done physical exercise. Moreover,
pregnant women who were never heard about antenatal exercise 52% times less likely to be
knowledgeable about antenatal exercise (9).

16
 2.3 Conceptual Frame Work
Concepts that directly associate with the major variable of knowledge and attitude towards
antenatal physical activity adapted from different literatures(7),(9),(20),(21),(22). This
conceptual framework emphasizes socio demographic characteristics, obstetrical history,
husband occupation and education level, participating in physical exercise before becoming
pregnant, and source of information.

Obstetrical history: Source of information Socio-demographic

(radio, television, characteristics:
 parity, newspaper etc.)
 gravidity,  age,
 gestational Knowledge and attitude  marital status,
 age status, towards physical activity  religion,
 number of
 employment,
children,
 income level
 history of and
pre-pregnancy Husband
miscarriage. occupation and educational
physical activity
level.
education level
 Occupation
 Ethnicity

Figure 1: Conceptual framework of knowledge and attitude towards physical activity during
pregnancy and its associated factors for pregnant women attending antenatal care at public health
institutions in Akaki-Kality sub city, Addis Ababa, Ethiopia, 2019.

17
Chapter Three: Objective of the Study
3.1 General objective
To assessment of knowledge and attitude towards physical activity during pregnancy and
associated factors among women attending antenatal care at public health institutions of Akaki-
kality sub city, Addis Ababa, Ethiopia, 2019.

3.2. Specific objective

 To assess knowledge of physical activity during pregnancy among pregnant women
attending antenatal care.
 To assess attitude towards physical activity during pregnancy among pregnant women
attending antenatal care.
 To identify factors associated with knowledge and attitude of physical activity during
pregnancy.

18
 Chapter Four: Methods and Materials
4.1. Study area and period
The study was conducted at public health institutions of Akaki-kality sub city, Addis Ababa,
Ethiopia. Akaki-Kality is one of the 10 sub-cities of Addis Ababa and has 11 woredas. It is
located in the south part of the city, bounded from east and south by Oromia region from west
Nifas silk-lafto, and from the north Nifas silk and Bole sub-city and it has area of 118.08 square
kilometers and its population is 220,740 with 114,095 female and 106,645 male based on 2007
Ethiopia central statistical authority (ECSA)(24, 25). It has 10 governmental health centers, 1
governmental hospital. The study will be conducted from February 15 to March 15, 2019.

4.2. Study design

Institutional based cross-sectional study design was employed.
4.3. Source of population and study population and participant
4.3.1 Source population
The source of a population was all pregnant women attending Antenatal care in Akaki-Kality sub
city at public health institutions.
4.3.2. Study population
The study population was all pregnant women attending Antenatal care at public health
institutions in Akaki-kality sub city during the study period.
4.3.3. Study participant
The study subject was selected pregnant women attending ANC at selected public health
institutions in Akaki-kality sub city during the study period and fulfill inclusion criteria.
4.4. Eligible Criteria
4.4.1. Inclusion criteria
 All pregnant women who are mentally and physically capable of being interviewed.
 The pregnant woman attending antenatal care Akaki-Kality sub city public health
institutions.
4.4.2. Exclusion criteria
 Pregnant women who are not mentally and physically capable of being interviewed.

19
4.5 Sample size determination
The sample size was determined by using a single proportion formula. A study conducted in
Addis Ababa on physical exercise showed the result of 43.4% and 52.1% knowledgeable and
have a positive attitude towards PA during pregnancy, respectively. So, the P value was adapted
from this study result through choosing the result which gives maximum sample size; that is a
positive attitude (52.1%). Marginal error was 5%, 95% confidence interval and 5%% non-
response rate was added. The total sample required was calculated to be 384.

n= ( )
Z
α 2
2
× P ( 1−P )
=
( 1.96 )2 ×0.521 ( 1−0.521 )
=384
2
d ( 0.05 )2

n= the required sample size

z= standard score corresponding to 95% confidence interval
p= Assumed proportion of antenatal physical exercise attitude 52.1% in order to have maximum
sample size
d= the margin of error (degree of accuracy)
Assuming 5% nonresponse rate then 384+ ( 384 ×0.05 ) =¿404
4.6. Sampling technique and procedure
We were select one hospital and four health centers from 10 health centers and that is found in
Akaki-Kality sub city through simple random sampling technique. After calculating the sample
size, we was taken pregnant women attending ANC at selected public health institutions in six
months as study population then sample from each selected public health institution was
allocated by using probability proportional to their population size; therefore, the sample taken
n × Ne
from each selected public health institution by proportional allocation, n e=
N
Where, ne= required sample size from each selected public health institution
n= the sample size
Ne= number of pregnant women in each public health institution
N= total number of pregnant women in the selected public health institution

20
Finally the study unit was selected by using systematic random sampling technique every k th
N 5802
interval,k = = =14 . So, between one up to fourteen, we will select the fifth by lottery
n 404
method.

Simple random sampling

Totalpublichealthinsti utioninAkaki-Kality Sub city

Akaki HC Tulu-dimtu HC
Serti HC Kality HC Tirunesh Bejing
General Hospital

Proportional allocation

Akaki HC Serti HC Tulu-dimtu Kality HC Tirunesh

HC Bejing
N=777n=5 N=620 N=1121n=
General
4 n=43 N=408 n=29 78 Hospital

N=2876
n=200

Systematic random sampling technique

21
 Respondents

n= 404
Figure 2: Schematic presentation of the sampling procedure

Where; N= total number of pregnant women attending ANC in each selected public health
institutions for six months.
n=number of samples
4.7. Study variable
4.7.1 Dependent variable
 Knowledge
 Attitude
4.7.2 Independent variables
 Socioeconomic characteristics: Age, religion, educational level, occupation, monthly
income and marital status.
 Pregnancy and obstetrical history (gravidity, Parity, gestational ages status, number of
children and history of miscarriage)
 Source of information (Media, health care provider. family or friends)
 Pre-pregnancy regular physical activity experience.
 Husband occupation and education level
4.8. Operational definition
Educational status: - refers to the level of education attended by the respondent during the time
of the survey.
Physical activity: defined as any bodily movement produced by the contraction of skeletal
muscles in all stages of life and it includes day to day activities (like walking, cooking) and
exercises.
Physical exercise: subtype of physical activity that consisting of planned, structured, and
repetitive bodily movements.
Knowledgeable: women were considered knowledgeable if they will aware of the physical
activity and its advantages during pregnancy, and if they scored mean or more of the knowledge
questions, and not knowledgeable if otherwise.

22
Favorable attitude: women were considered as having a favorable attitude towards physical
activity and its advantages, and if they scored the median or more of the attitude questions, and
unfavorable if otherwise.
Knowledge of antenatal physical activity: Knowledge of antenatal physical activity means
knowing or understanding the benefit and contraindication of antenatal physical activity.
Attitude: A settled way of thinking or feeling towards of antenatal physical activity.
Physically capable: when a woman free from any bodily restriction or paralysis and loss of
extremities that are a barrier to do physical activity.
Mentally capable: when a woman can respond correctly when she is asked.
4.9 Data collection instrument and procedure
For this study, we used a structured questionnaire which adapted and modified from other
study(9). The questionnaire was first prepared in English language and translated to the Amharic
language and then back to English language. The data was collected through face to face
interview.
4.10 Data quality assurance
To maintain data quality pretest was conducted in Saris health center and the questionnaire was
translated to Amharic language. We were give instructions for our participants. Moreover, we
were check for missed and incomplete data after collection of data.
4.11 Data processing and analysis
After data collected, data was edited, coded, and cleaned. It was analyzed by computer statistical
package for social science (SPSS) version 21 and Epi Data 3.1. For describing categorical
variables, we were used frequency tables and Charts. And for describing numerical variables we
were used graphs, central tendency and standard deviations.
Bi-variable and multi-variable level analysis using logistic regression was done to identify
factors that are independently associated with the dependent variable if variables with P≤0.2 for
multivariate variable associated with p<0.05 was reported as statically significant.
4.12 Dissemination of results
The result of this study will be disseminated to Debre Berhan University college of health
science department of midwifery for partial fulfillment of Bachelor of science degree in
midwifery. It will also be disseminated to concerned governmental and non-governmental
organizations. It will be sent for publication in peer-reviewed journal.

23
4.13 Ethical consideration
Ethical clearance was given from Debre Berhan University (DBU), college of health sciences,
department of Midwifery research committee. Researchers were explained the objectives of the
study and the information was collected from study participants remain confidential.
All the study participants were informed verbally on the purpose before interviewed and, as there
is no direct benefit of the study. In addition to this, for the participants it was not have any
potential risks, participants have the right to refuse at any time, and there is no discrimination
among participants.

5. RESULT
5.1 Socio-economic characteristics of pregnant women attending ANC at public health
institutions in Akaki-kality sub city, Addis Ababa, 2019.
From the total of 404 respondents, 399 participates were giving response. Mean age of the
respondents was 27.89 with standard (SD) deviation of ± 4.72 years with a minimum age of 17
and maximum age of 40. The majority of the respondents were in the age range of 25-29 years
176 (44.1%).
In their religion, 241 (60.4 %) were Orthodox. Out of the total 399 respondents, 376 (94.2%)
were married followed by 11 (2.8%) single.
The educational status of the respondents, 99 (24.8%) were high school. Educational status and
occupational status of the majority of the respondents’ husband, 120 (30.1%) were college or
university and 114(28.6%) were merchant. In their occupational status of the majority of
respondents 204 (51.1%) were house wife. From the total of respondents, 168(42.1%) were
Oromo.

Table 1: Socio-economic characteristics of pregnant women attending ANC at public health

institutions about physical activity during pregnancy in Akaki-Kality sub city, Addis Ababa,
2019(n=399).

Variables Frequency Percent(%)

Age 15-19 7 1.7

24
 20-24 84 20.8

25-29 177 .43.8

30-34 95 23.5

35 and above 41 10.1

Marital status Single 11 2.8

Married 376 94.2

Divorced 7 1.8

Separated 3 0.8

Widowed 2 0.5

Religion Orthodox 241 60.4

Protestant 65 16.3

Catholic 18 4.5

Muslim 74 18.5

Others 1 0.3

Educational Illiterate 76 19
level
Reading and writing 60 15

Elementary 80 20.1

High school 99 24.8

College or university 84 21.1

Educational Illiterate 24 6.4

status of
Reading and writing 40 10.6

25
husband (376) Elementary 74 19.7

High school 118 31.4

College or university 120 31.9

Occupation Government employee 72 18

House wife 204 51.1

Private business 94 23.6

Employed in NGO 26 6.5

Others 3 0.8

Occupation of Government employee 107 28.4

husband
Merchant 114 30.5
(376)
Daily worker 99 24.8

Driver 22 5.8

Private work 21 5.5

Others 13 3.2

Ethnicity Oromo 168 42.1

Amhara 129 32.3

Tigre 59 14.8

Gurage 14 3.6

Silte 11 2.8

Others 18 4.5

Average <2000 65 16.3

26
monthly ≥2000 334 83.7
income

5.2 Obstetrical characteristics of pregnant women ANC at public health institutions in

Akaki- kality sub city
Majority of the respondents 246 (61.7%) were multigravida and from 246 multigravidas 130
women were primiparas and 116 women were multiparas. From 399 46(11.6%) of respondents
had history of abortion. One hundred fourthly six respondents had one child followed by three
of the respondents had four alive children and 151 (37.4%) of the participants their gestational
age were four up to six months followed by 142 (35.1%) seven up to nine months.

Table 2: obstetrical characteristics of pregnant women attending ANC at public health

institutions about physical activity during pregnancy in Akaki-Kality sub city, Addis Ababa,
2019(n=399).

Characteristics Frequency Percent(%)

Gravidity Premigravida 136 33.7

Multigravida 268 66.3

Parity (N=246) Premipara 130 53.5

Multipara 116 46.5

Number of child they No child 19 7.7

have(N=246)
One 139 56.5

Two 66 26.8

Three 21 8.5

Four or more 1 0.4

Gestational age status of Three or less month 82 20.6

this pregnancy

27
 Four – six month 138 34.6

Seven – nine month 131 32.8

Greater than nine month 48 12

History of abortion 46 11.6

5.3 Sources of information and pre-pregnancy physical activity.

From the total of 399 respondents 203 (50.9%) were heard about physical activity during
pregnancy. The main source of their information was health care provider. Majority of
respondents 222 (55.6%) hadn’t done physical activity before becoming pregnant.

Table3 Sources of information and pre-pregnancy physical activity of pregnant women

attending ANC at public health institutions about physical activity during pregnancy in Akaki-
Kality sub city, Addis Ababa, 2019(n=399).

Characteristics Frequency Percent(%)

Ever heard about antenatal physical activity

Yes 203 50.9

No 196 49.1

Sources of information antenatal physical activity

heard(N=203)

Television 99 24.8

Radio 21 5.3

Friends 35 8.8

28
 Health care provider 108 27.1

Internet 21 5.3

Type of antenatal physical activity heard(N=203)

Day to day activity 143 35.8

Walking 166 41.6

Aerobics 6 2.3

Swimming 18 4.5

Relaxation/breathing 65 16.3

Ankle or toe exercise 52 13

Ever done physical activity before becoming pregnant

Yes 170 42.6

No 229 57.4

Type of physical activity ever done

(N=170)

Day to day activity 152 38.1

Walking 101 25.3

Aerobics 6 1.5

Swimming 13 3.3

Relaxation/breathing 30 7.5

Running 30 7.5

Others 17 4.3

29
 1 0.3

5.4 Knowledge about the benefit and contra indication of physical activity during
pregnancy among pregnant women attending ANC at public health institutions in
Akaki-Kality sub city, Addis Ababa.
This study assessed knowledge about benefit and contraindication of physical activity during
pregnancy among pregnant women attending ANC. From the total of 399 respondents by
computation of overall knowledge questions the respondents mean = 5.72 median 6 = SD=3.63.
Therefore majority of respondents 224(56.1%) were knowledgeable about antenatal physical
activity.

Table 4:Knowledge about the benefit and contraindication of physical activity during
pregnancy among pregnant women attending ANC at public health institutions Akaki-
Kality sub city, Addis Ababa, Ethiopia, 2019 (n=399).

Characteristics Frequency Percent (%)

Reduce risk of back pain

Yes 193 48.4

No 21 5.3

I don’t know 185 46.4

Prevents excessive weight gain

Yes 260 65.2

No 20 5

I don’t know 119 29.8

30
Reduce labor and delivery pain

Yes 187 46.9

No 34 8.5

I don’t know 178 46.4

Reduce risk of gestational diabetes mellitus

Yes 155 38.8

No 31 7.8

I don’t know 213 53.4

Decrease high blood pressure during pregnancy

Yes 220 55.1

No 27 6.8

I don’t know 152 38.1

Prevents antenatal and postnatal depression

Yes 209 52.4

No 24 6

I don’t know 166 41.6

Helps more rapid postnatal recovery

31
 Yes 206 51.6

No 46 11.5

I don’t know 147 36.8

Benefit for general health and development of the baby

Yes 294 73.7

No 10 2.5

I don’t know 95 23.8

Poorly controlled type 1 Diabetic during pregnancy

Yes 84 21.1

No 70 17.5

I don’t know 245 61.4

Premature labor during pregnancy

Yes 156 39.1

No 43 10.8

I don’t know 200 50.1

Premature rupture of membrane

Yes 189 47.4

32
 No 34 8.5

I don’t know 176 44.1

Preeclampsia

Yes 128 32.1

No 84 21.1

I don’t know 187 46.9

Knowledge of physical activity during pregnancy

Knowledgeable 224 56.1

Not knowledgeable 175 43.9

5.5 Attitude towards physical activity among pregnant women attending ANC
About 345 (86.5%) respondents were think physical activity is necessary and 120 (30.1%) felt
physical activity during pregnancy is risky for the fetus. The mean , median and SD of the
respondent’s attitude score was 5.05, 5 and 2.02 respectively. Based on the mean of the attitude
score 210 (52.6%) respondents had poor attitude about physical activity during pregnancy.

Table 5:Attitude of towards physical activity during pregnancy among pregnant women
attending ANC at public health institutions Akaki-Kality sub city, Addis Ababa, Ethiopia, 2019
(n=399).

Characteristics Frequency Percent(%)

Think about physical activity is necessary

33
during pregnancy

Yes 345 86.5

No 18 4.5

I don’t know 36 9

Think physical activity during pregnancy is

risky to the fetus

Yes 120 30.1

No 193 48.4

I don’t know 86 21.6

Think physical activity during pregnancy

suit with our culture

Yes 257 64.4

No 48 12

I don’t know 94 23.6

Think physical activity during pregnancy

suit with our religion

Yes 253 63.4

No 51 12.8

34
 I don’t know 95 23.8

Think pregnant women should perform exercise under the

guidance of health care provider

Yes 312 78.2

No 31 7.8

I don’t know 56 14

Think physical activity during pregnancy reduce pregnancy related

complications

Yes 283 70.9

No 31 7.8

I don’t know 85 21.3

Think physical activity during pregnancy post-delivery recovery

Yes 231 57.9

No 42 10.5

I don’t know 126 31.6

Think physical activity regimen during pregnancy should vary

from one pregnant mother to another

Yes 217 54.4

35
 No 63 15.8

I don’t know 120 29.8

Unfavorable attitude 210 52.6

Favorable attitude 189 47.4

5.6 Associated factors related to knowledge about physical activity during pregnancy
among pregnant women attending ANC.

…… we will write the significant factors

Table 7: Bivariate and multivariate analysis of determinant for knowledge of physical activity
during pregnancy among pregnant women at public health institutions Akaki-Kality sub city,
Addis Ababa, Ethiopia, 2019.

Variables Not Knowledgea COR AOR

knowledge ble
able

Income level

<2000ETB 21 44 1.00 1.00

≥2000ETB 154 180 0.558(0.318,0.979) 2.433(1.181,5.

36
 012)

Occupation

Government employee
23 49 1.00 1.00

House wife
89 115 0.607(0.344,1.070) 4.261(0.367,4
9.428)

Private business
47 47 0.469(0.248,0.890) 2.584(0.231,2
8.956)

14 12 0.402(0.161,1.006) 2.000(0.175,2
Employed in NGO 2.815)

Others
2 1 0.235(0.20,2.723) 1.714(0.138,2
1.333)

Occupational status of the husband

Government employee
34 73 1.00 1.00

Merchant
45 69 0.714(0.410,1.242) 1.769(0.426,7.
346)

Daily worker
60 39 0.303(0.171,0.537) 2.413(0.639,9.
104)

Driver
6 16 1.242(0.447,3.454) 0.961(0.244,3.

37
 783)

Private business
8 13 0.757(0.287,1.997) 2.778(0.549,1
4.048)

Other
8 5 0.291(0.089,0.956) 1.5.4()

Educational satus

Illiterate
33 43 1.00 1.00

Reading and writing

33 27 0.628(0.318,1.241) 1.164(0.439,3.
088)

Elementary
41 39 0.730(388,1.372) 0.436(0.183,1.
036)

High school
44 55 0.959(0.525,1.752) 0.632(0.271,1.
476)

College or university
24 60 1.919(0.996,3.696) 0.462(0.218,0.
98)

Educational status of
the husband

Illiterate 19 5 1.00 1.00

38
Reading and writing
25 15 2.280(0.704,7.382) 0.236(0.60,0.9
26)

Elementary
37 37 3.800(1.283,11.251) 584(0.209,1.6
34)

High school 38 80 8.00(2.777,23.047) 1.023(0.44,2.3

76)

College or university
42 78 7.057(2.459,20.250) 1.379(0.663,2.
944)

Heard about physical activity

Yes
53 122 1.00 1.00

No
150 74 0.214(0.140,0.328) 3.516(2.097,5.
895)

Ever done physical activity before pregnancy

Yes
55 115 1.00 1.00

No
120 109 0.434(0.287,0.657) 0.26(1.811,1.0
75)

5.7 Associated factors related to attitude towards physical activity during pregnancy
among pregnant women attending ANC.

39
 6. References
1. ACOG. Physical Activity and Exercise During Pregnancy and the Postpartum

Period. committe opinion no650. 2017;650.

2. CJ caspersen KP, GM christenson. physical activity, exercise, and physical fitness:
definitions and distinctions for health related reseach. public health reports. 1985;100(2):126.
40
3. Melanie S. Poudevigne PJOC. A Review of Physical Activity Patterns in Pregnant
Women and Their Relationship to Psychological Health. Sports Medicine. 2006;36(1):19-38.
4. Gary Cunningham F KJL, Steven L. Bloom, Jodi S. Dashe, Barbara Hoffman L. .
Williams obstetrics. 25 ed. Dallas Texas: Mc GrawHill Education; 2018.
5. I s. Importance of physical awarness in pregnant women. journal of medical and health
science 2016.
6. p DK. Knowledge and attitude with respect to physical activity during pregnancy among
pregnant women attending antenatal clinic. international journal of advances in nursing
management. 2015;3(1).
7. Chidozie E M, Olubukayomi E, Adebayo, Adebanjo B, Adeyemi, et al. knowledge and
attitude of Nigerian pregnant women towards antenatal exercise- a cross sectional survey. Online
ISRN Obstet Gynecol. 2014;2014.
8. Hjorth MF KS, Girma T, Faurholt-Jepsen D, Andersen G, Kæstel P, et al. Level and
intensity of objectively assessed physical activity among pregnant women from urban

Ethiopia. BMC pregnancy and childbirth. 2012;12(1):154.

9. T B. Assessment of Knowledge, Attitude, Practice Towards Antenatal Exercise And Its
Associated Factor Among Pregnant Women Attending Antenatal

Care addis ababa: addis ababa university; 2018.

10. Danielle Symons Downs LcT, kelly R. Evensen, Jenn leiferman, SeonAe Yeo. physical
activity and pregnancy. Res Q Exercise sport. 2012;83(4):485-502.
11. Kelly R. Evenson RB, Wondy J. Brown, Patricia Dargent - Molina, Megumi Haruna,
Ellen M. Mikkelsen .et al. guidelines for physical activity during pregnancy. Am J Life style
Med. 2014;8(2):102-21.
12. Estelle D. Watson B, demitri Constantinou. Exercise during pregnancy: knowledge and
belif of medical practitioners in south africa a survey study. BMC pregnancy and childbirth.
2015;15:245.
13. Marlos. R DG, Shana. G, Carlina. D, Bruna. G, Pedro. C. physical activity during
pregnancy amd maternal-child health: study protocol for a randomized controlled trial. Trials.
2015;16:227.
14. WHO. maternal mortality. 2018.

41
15. Pearson. T WE, Lambert. L, Micklesfield. L. The role of physical activity during
pregnancy in determining maternal and fetal outcomes. south africa journal of sport medicine.
2015;27(4).
16. kumar V NA, Thunga S, Mithra P, Nayak R, Paes L, Gubpta C. Knowledge, Perception,
and Attitude of Pregnant Women Towards the Role of

Physical Therapy in Antenatal Care-A Cross Sectional Study. online journal of health and allied
science. 2016;14(4):6.
17. Zoe Weir JB, Stephen C. Robson, Catherin MC Parlin, Judith Rakin , Ruth Bell phsical
activity in pregnancy :a qualitative study of the beliefs of overweight and obese pregnant
women. BMC pregnancy and childbirth. 2010;10:18.
18. Wijesiriwardana WS GN. Knowledge, attitudes and practices regarding antenatal
exercises among pregnant mothers attending De Soyza Maternity Hospital

Colombo. Sri Lanka Journal of Obstetrics and Gynaecology. 2015:65-71.

19. Carmen. P HM. Knowledge, attitude and practice of women in campinas, Sao
paulo,Brazil with respect to physical exercise in pregnancy: a descriptive study. reproductive
health. 2011;8:31.
20. Dr Hussen Abu al Rahi DSA-K, Dr Rasha Al Awwad, Dr Samia Ahmed, Dr Arij Al-
Thubaiti. knowlede and practice physical activity among pregnant following in primary health
care centers in the eastern province International Journal Of scientific research. 2018;7(7):51-5.
21. Sujindra E BA, Suganya A, Praveena R. . Knowledge, attitude, and practice of exercise
during pregnancy among antenatal mothers. International Journal of Educational and
Psychological Researches. 2015;1(3):234.
22. Rachana Nayak LP, C Gu, Vijaya Kumar. knowledge, perception and attitude of pregnant
women towards the role of physical therapy in Antenatal Care- a cross sectional study Online
journal of health and allied science. 2015;14(4).
23. Wing Man Put S-LC, Lin-Wai CHAN. Attitude and practice of Hong Kong Chinese
women towards physical activity in pregnancy – a prospective cohort study. Physical activity in
pregnancy. 2015;15(2):138.
24. EDA. Akaki-kality sub city 2015.
25. Wikipedia. Akaki Kaliti 2017.

42
 7. Annexes

Annex Ⅰ: Information sheet

This questionnaire prepared to studying on assessment of knowledge and attitude on physical
activity during pregnancy and its associated factors among pregnant women attending antenatal
care in Akaki-Kality sub city at public health institutions. For this study, you will be selected as a
participant and before getting your volunteer and permission of your participation and you
should know all necessary information related to this study. The detail as follow: -Objective of
the study: assessment of knowledge and attitude towards physical activity and associated factors

43
among pregnant women attending antenatal care at public health institution of akaki-kality sub
city, Addis Ababa, Ethiopia.

Significant of the study: The finding of this research will help for policy makers and for health
care providers in decision making process about physical activity during pregnancy. For future
researcher, this study will be an opening door and or it gives base line information. Participants
to be included for this study: All pregnant mothers who are attending antenatal care at public
health institutions during the study period and the fulfill inclusion criteria. Risks and benefits of
the study: The procedure has not any physical or psychological trauma and you will not be
forced to respond to the question if you do not know. There is no payment for your participation
in the study and there is no any risk if you not participating but you should be give relevant
information which is important for answer the questions asked to improve health of pregnant
women and their fetus.

Confidentiality: All information you give will be kept confidential and will not be given to
other third body. Your name will not be known on the question sheet.

Annex Ⅱ: Consent Form

Good morning/afternoon. My name is ___________________ and I am fourth year
undergraduate midwifery student. I came from Debre Berhan University College of health
science department of midwifery. We are studying on knowledge and attitude towards physical
activity during pregnancy and its associated factor among pregnant women who are attending
antenatal care in the Akaki-Kality sub city public health institutions. We would like you to
respond to only if you are volunteer. I assure that the information you provide will be kept
confidential. Your name will be not written on the questionnaire to ensure your confidentiality.
Make sure that, there is no any harm and direct benefit because you are involved in this study.
You have full right to refuse to the interview partially or totally. And this interview needs fifteen

44
minutes. If you are volunteer to interview you should answer the questions carefully that used
for the recommendations of Ethiopian ministry of health and health facility services.

Consent

I have fully understood its content and I have agreed to participate in this research project.

Yes ___________

No ___________

Thank you for giving your consent.

Name of Data Collector---------------- Sign-------------------------Date-------------------

Code_________________ participant signature_____________ house number___________

Annex Ⅲ: English Questionnaire

Instruction to the interviewer: Circle the alternative letter/s that contains the answer/s and for
Questions that you give direct answer, write the answer in the blank space.
Part Ⅰ: Questions related Socio demographic characteristics

Serial Characteristics Alternative answers

no.

Q.1.01 What is your age? ________ _years

Q.1.02 What is your religion? A. Orthodox

B. protestant
C. Catholic

45
 D. Muslim
E. Others
specify_______________
Q.1.03 What is your current marital status? A. Single
B. Married
C. Divorced
D. Separated
E. Widowed
Q.1.04 What is your educational level? A. Illiterate
B. Reading and writing
C. Elementary
D. High School
E. College or university
Q.1.05 What is the educational Status of your A. Illiterate
husband? B. Reading and writing
C. Elementary
D. High School
E. College or university
Q.1.06 What is your occupation? A. Employed in governmental sectors
B. House wife
C. Private business /trader
D. Employed in NGO
E. Other specify__________________
Q.1.07 What is the occupational status of your A. Employed (Government/Private)
husband? B. Merchant
C. Daily worker
Other specify___________

Q.1.08 What is your ethnicity? A. Tigre

B. Amhara
C. Oromo

46
 D. Others specify ________
Q.1.09 What is your income level per a month? _______________ Ethiopian birr

Part Ⅱ: Obstetrical history

Q.2.01 How many times in total you became A. One times

pregnant including this pregnancy? B. Two times
C. Three times
D. ≥ four
Q.2.02 How many times in total you gave A. One times
birth greater than seven months of B. Two times
pregnancy? C. Three times
D. ≥ four times
Q.2.03 How many alive children do you have A. I haven’t
now? B. One
C. Two
D. Three
E. ≥Four
Q.2.04 How many histories of abortion do A. I haven’t
have you before? B. One
C. Two
D. Three
E. Four
F. ≥ five
Q.2.05 What is gestational age status of this A. ≤ three months
pregnancy now in completed months? B. Four – six months
C. Seven – nine months
D. Greater than nine months
Part Ⅲ: Question related to sources of information and pre-pregnancy physical activity.

47
Q.3.01 Have you heard about physical A. Yes
activity during pregnancy? B. No

Q.3.02 If the answer for question number A. Television

301is yes, where do you get the B. Radio
information? (you can choose more C. Friends
than one answer) D. Health care provider
E. Internet
F. Other specify________________

Q.3.03 If the answer for 301 is yes, What A. Day to day activity like cooking,
types of physical activities you heard? baking etc.
(you can choose more than one B. Walking
answer). C. Aerobics
D. Swimming
E. Relaxation/ breathing
F. Ankle and toe exercise
G. Other specify________________

Q.3.04 Have you ever done physical activity A. Yes

before becoming pregnant? B. No

Q.3.05 If your answer for question number A. Day to day activity like cooking,
304is yes, what type of physical baking etc.
activity you done? B. Walking
C. Aerobics
D. Swimming
E. Relaxation
F. Running
G. Gym sport
H. Other specify________________

48
Part Ⅳ: Questions concerning knowledge towards benefit of physical activity during pregnancy.

Instruction to the interviewer: If the statement is correct circle A, incorrect circle B and if you are
unsure circle C.

Q.4.01 Physical activity during pregnancy A. Yes

reduces risk of back pain B. No
C. I don’t know
Q.4.02 Physical activity Prevents excessive A. Yes
weight gain during pregnancy B. No
C. I don’t know
Q.4.03 Physical activity can help cope with A. Yes
labor and delivery pain B. No
C. I don’t know
Q.4.04 Physical activity during pregnancy can A. Yes
reduces risk of gestational diabetes B. No
C. I don’t know
Q.4.05 Physical activity can decrease high A. Yes
blood pressure during pregnancy. B. No
C. I don’t know
Q.4.06 Physical activity prevents antenatal A. Yes
and postnatal depression B. No
C. I don’t know
Q.4.07 Physical activity benefits for general A. Yes
health and development of the baby. B. No
C. I don’t know
Q.4.08 Physical activity helps more rapid A. Yes
postnatal recovery. B. No
C. I don’t know

49
Q. 4.09 Poorly controlled type 1 Diabetic A. Yes
during pregnancy is contraindicated to B. No
do exercise during pregnancy C. I don’t know

Q. 4.10 Premature labor during pregnancy is A. Yes

contraindicated to do physical activity B. No
during pregnancy. C. I don’t know

Q. 4.11 Premature rupture of membrane is A. Yes

contraindicated to do physical activity B. No
C. I don’t know
Q. 4.12 Preeclampsia is one of contraindicated A. Yes
to do physical activity B. No
C. I don’t know

Part Ⅴ: Question concerning attitude of towards physical activity during pregnancy.

Instruction to the interviewer: If the statement is correct circle A, incorrect circle B and if you are
unsure circle C.

Q.5.01 Do you think physical activity during A. Yes

pregnancy is necessary? B. No
C. I don’t know
Q.5.02 Do you feel physical activity during A. Yes
pregnancy is risky to the fetus? B. No
C. I don’t know
Q.5.03 Does antenatal physical activity suit A. Yes
with our culture? B. No
C. I don’t know
Q.5.04 Does physical activity during A. Yes
50
 pregnancy suit with our religion?
B. No
C. I don’t know
Q.5.05 Do you belief pregnant women should A. Yes
perform exercise under the guidance B. No
of health care professionals? C. I don’t know

Q.5.06 Do you feel physical activity during A. Yes

pregnancy can reduce pregnancy- B. No
related complications? C. I don’t know

Q.5.07 Do you feel physical activity during A. Yes

pregnancy helps in post-delivery B. No
recovery? C. I don’t know

Q.5.08 Do you feel physical activity regimen A. Yes

should vary from one pregnant woman B. No
to another? C. I don’t know

THANK YOU FOR YOUR PARTICIPATION!

Annex2: Amharic questionnaire

ANNEX I - የመረጃ ወረቀት

ይህ መጠይቅ የተዘጋጀው በአቃቂ ቃሊቲ ክፍለ ከተማ የህዝብ ጤና ተቁዋም የቅድመ ወሊድ ክትትል ለሚያደርጉ ነፍሰጡር
እናቶች ስለ ቅድመ ወሊድ የአካል እንቅስቃሴ ያላቸውን እውቀትና አመለካከት እንድሁም ተያያዥ ምክንያቶች ላይ የዳሰሳ
ጥናት ለማድረግ ነው፡፡ በዚህ ጥናት እርስዎ ተሳታፊ እንድሆኑ ተመረጡዋል፡፡ እርስዎ ፍቃደኛ ከመሆንዎ በፊት ከጥናቱ ጋር
ተያያዥ የሆኑ ሁሉንም አስፈላጊ መረጃዎችን ማወቅ አለብዎት፡፡ ስለሆነም ይህ መረጃ በሚከተለው ዝርዝር መሰረት
ይቀርባል፡-

የጥናቱ አላማ፡ በአቃቄ ቃሊቲ ክፍለ ከተማ የመንግስት ጤና ተቋም የቅድመ ወሊድ ክትትል ለሚከታተሉ ነፍሰ ጡር እናቶች
ስለ ቅድመ ወሊድ የአካል እንቅስቃሴ ያላቸውን እውቀትና አመለካከት እንዲሁም ተያያዥ ምክንያቶች ላይ የዳሰሳ ጥናት
ለማድረግ ነው፡፡

51
የጥናቱ ጠቀሜታ፡ የዚህ ጥናት ግኝቶች በተለመደው የቅድመ ወሊድ የአካል እንቅስቃሴ ዙሪያ በሚያደርጉ የውሳኔ ሰጪ
ሂደቶች ለሚመለከታቸው የፖሊሲ አውጪዎችና ጤና አገልግሎት ሰጪዎችሻ ውሳኔዎችን ለመወሰን ጠቃሚ ግብዓት ሊሆን
ይችላል፡፡በተጨማሪም ለወደፊት ጥናትና ምርምር ለሚያደርጉ ተመራማሪዎች ወይም አጥኚዎች በር ከፋች ወይም መረጃ
ሰጪ ሊሆን ይችላል፡፡

ምስጢራዊነቱ: የሚሰጡት መረጃ ሁሉ በምስጢር የሚጠበቅ ሲሆን እና ለማናቸውንም ሶስተኛ ወገኖች ተደራሽ አይሆንም.
በጥያቄ ወረቀትዎ ላይ ስምዎ በምርጫው ውስጥ አይካተትም::

በጥናቱ ውስጥ የሚካተቱ ተሳታፊዎች፡ በአቃቂ ቃሊቲ ክፍለ ከተማ በተመረጡ የመንግስት ጤና ተቋም የቅድመ ወሊድ
ክትትል ለሚያደርጉና በጥናቱ ሰዓት የተገኙ ሁሉም ነብሰጡር እንድሁም መስፈርቱን የሚያሟሉ፡፡

የጥናቱ አደጋዎችና ጥቅሞች፡ ይህ ጥናት ሲካሄድ ምንም ዓይነት አካላዊ ወይም ስነ-ልቦናዊ ጉዳት የለውም. በተጨማሪም,
ለማያውቁት መረጃ ምላሽ እንዲሰጡ አይገደዱም. በጥናቱ ውስጥ ስለተሳተፉ ምንም ክፍያ የለውም, ስላልተሳተፉም ምንም
አይነት ጉዳት አይደርስብዎትም፤ ነገር ግን በጥናቱ ላይ በመሳተፍዎና ለተጠየቁት ጥያቄዎች ትክክለኛ መረጃችን በመስጠት
የእናቶችን እና የህፃናትን ጤና ለማሻሻል ለሚደረጉ ጥረቶች ከፍተኛ አስተዋፅኦ ይኖረዋል፡፡

ANNEX II - የስምምነት ማስገንዘቢያ ቅፅ

እንደምን አደሩ/አረፈዱ፡፡ ስሜ ------------------- ሲሆን የደብረ ብርሃን ዩንቨርሲቲ የሚድዋይፈሪ የ 4 ኛ አመት ተመራቂ
ተማሪ ነኝ፡፡በአቃቂ ቃሊቲ ክፍለ ከተማ በተመረጡ የመንግስት ጤና ተቋም የቅድመ ወሊድ እንክብካቤ የሚከታተለ ነፍሰ
ጡር ሴቶች ስለ ቅድመ ወሊድ የአካል እንቅስቃሴ ያላቸውን እውቀትና አመለካከት እንዲሁም ተያያዥ ምክንያቶን
በተመለከተ የዳሰሳ ጥናት ላይ እንገኛለን፡፡ምላሽዎን የሚሰጡን ፍቃደኛ እስከሆኑ ድረስ ብቻ ሲሆን የሚሰጡን መረጃዎች
ሙሉ በሙሉ ምስጥራዊነታቸዉ የተጠበቀ ነው፡፡የእርስዎን ማንነት በሚስጥር ለመጠበቅ ሲባል ስምዎ በመጠይቅ ቅጹ ላይ
አይካተትም፡፡በቃለ መጠይቁ ላይ በከፊልም ይሁን ሙሉ በሙሉ አለመሳተፍ የሚቻል ሲሆን ቃለ መጠይቁ የሚወስደው ጊዜ
15 ደቂቃዎች ነው፡፡ እርስዎ በዚህ ጥናት ላይ በመሳተፍዎ ምክንያት ምንም ጉዳት አይፈጥርብዎትም እናም ምንም አይነት
ቀጥተኛ የሆነ ጥቅም የለውም፡፡ በቃለ መጠይቁ ላይ ለመሳተፍ ፍቃደኛ ከሆኑ የሚሰጧቸው ምላሾች ለኢትዮጵያ የጤና ጥበቃ

52
ሚኒስቴር እና ለጤና አገሌግልት መስጫዎች ማሻሻያ የሚያግዙ በመሆናቸው እባክዎ መመለስ ለሚፈልጓቸው ጥያቄዎች
ትክክለኛ ምላሾችዎን ይስጡን፡፡

የመጠይቁን ሙሉ ይዘቶች ተገንዝቤ በዚህ የምርምር ጥናት ፕሮጀክት ላይ ለመሳተፍ ፍቃደኛ ሆኛለሁ፡፡

አዎ ____________

አይሆንም ____________

ፍቃደኛ ስለሆኑ እናመሰግናለን

የዳታ ሰብሳቢው ስም ---------------------- ፊርማ ---------------------- ቀን -----------------

ኮድ_____________ የተሳታፊ ፊርማ_________ የቤት ቁጥር_________

መመሪያ ለጠያቂው፡ ለሚመርጡት መልስ የያዘውን ፊደል ያክብቡ፤ ቀጥተኛ መልስ ለሚሰጡባቸው ጥያቄዎች መልስዎን
በተሰጠው ክፍት ቦታ ላይ ይጻፉ፡፡

ክፍል 1: ማህበራዊ እና ኢኮኖሚ ሚመለከቱ ጥያቄዎች

ተ/ቁ ጥያቄዎች አማራጭ ምላሾች

ጥ. 101 እደሜዎ ስንት ነው? ___________አመት

ጥ. 102 የምን ሀይማኖት ተከታይ ነዎት? A. ኦርቶዶክስ

B. ፕሮቴስታንት

53
 C. ካቶሊክ
D. ሙስሊም
E. ሌላ (ይገለፅ)____________
ጥ. 103 አሁን የጋብቻ ሁኔታዎ ምንድን ነው? A. ያላገባች
B. ያገባች
C. የፈታች
D. የተለያየች
E. ባል የሞተባት
ጥ. 104 የትምህርት ደረጃዎ ምንድን ነው? A. ያልተማረች
B. ማንበብና መጻፍ የምትችል
C. አንደኛ ደረጃ
D. ሁለተኛ ደረጃ ያጠናቀቀች
E. ኮሌጅ ወይም ዩኒቨርሲቲ
ጥ. 105 የባለቤትዎ የትምህርት ደረጃ ምንድን ነው? A. ያልተማረ
B. ማንበብና መጻፍ የሚችል
C. አንደኛ ደረጃ
D. ሁለተኛ ደረጃ ያጠናቀቀ
E. ኮላጅ ወይም ዩኒቨርሲቲ
ጥ. 106 ስራዎ ምንድን ነው? A. የመንግስት ሰራተኛ
B. የቤት እመቤት
C. የግል ስራ በግሌ ተቀጠሬ
D. መንግስታዊ ያልሆነ ድርጅት ሰራተኛ
E. ሌላ ካለ (ይገለፅ)_________________
ጥ. 107 የባለቤትዎ ስራ ሁኔታ ምንድን ነው? A. የመንግስት ሰራተኛ (የመንግስት ወይም የግል)
B. ነጋዴ
C. የቀን ሰራተኛ
D. ሌላ ካለ (ይገለፅ)_________________
ጥ. 108 ብሔርዎ ምንድን ነው? A. አማራ
B. ትግሬ
C. ኦሮሞ
D. ሌላ ካለ (ይገለፅ)__________________

54
ጥ. 109 ወርሃዊ ገቢዎ ምን ያህል ብር ነው? ________________ብር

ክፍል Ⅱ ከእርግዝናና ከወሊድ ጋር የተያያዙ ጥያቄዎች

ተ/ቁ ጥያቄዎች አማራጭ መልሶች

ጥ. 201 ይሄን እርግዝና ጨምሮ ስንተኛ እርግዝናዎ A. አንድ ጊዜ

ነው? B. ሁለት ጊዜ
C. ሶስት ጊዜ
D. አራት እና ከዛ በላይ
ጥ.202 ከሰባት ወር በላይ የሆነ ስንት ልጅ ወልደው A. አንድ
ውቃሉ? B. ሁለት
C. ሶስት
D. አራት እና ከዛ በላይ
ጥ.203 ምን ያህል ልጆች በሕይወት አሉዎት? A. የለኝም
B. አንድ
C. ሁለት
D. ሶስት
E. አራት እና ከዛ በላይ
ጥ.204 ከዚህ በፊት ስንት ጊዜ ውርጃ አጋጥመዎት A. የለም
ያውቃል? B. አንድ ጊዜ
C. ሁለት ጊዜ
D. ሶስት ጊዜ
E. አራት እና ከዛ በላይ
ጥ.205 እርግዝናዎ ስንት ወር ይሆነዋል? A. ≤ 3 ወራት
B. 4-6 ወራት
C. 7-9 ወራት
D. >9 ወራት
ክፍል 3፡ የቅድመ ወሊድ የአካል እንቅስቃሴዎች ግንዛቤን፤ የመረጃ ምንጭን እና ከእርግዝና በፊት ያሉ የአካል፤
እንቅስቃሴዎችን የሚመልከቱ ጥያቄዎች

ተ/ቁ ጥያቄዎች አማራጭ መልሶች

55
ጥ. 301 ስለ ቅድመ ወሊድ የአካል እንቅስቃሴዎች A. አዎ
ሰምተው ያውቃሉ? B. አላውቅም

ጥ. 302 ለጥያቄ ቁጥር 301 መልስዎ አዎ ከሆነ ስለ A. ከቴሌቪዢን

እንቅስቃሴዎቹ ከየት ነው ተማሩት (መረጃው B. ከሬዲዮ
ያገኙት)? C. ከጓደኛ
D. ከጤና ባለሙያ
E. ከኢንተርኔት
F. ሌላ ካለ ይገለፅ--------------------------
ጥ. 303 ለጥያቄ ቁጥር 301 መልስዎ አዎ ከሆነ A. የእለት ከለት ስራዎች ለምሳሌ ማብሰል፣ መጋገር
ከሚከተለት ውስጥ የትኞቹን የቅደመ ወሊድ B. መራመድ/የእገር ጉዞ ማድረግ (Walk)
የአካል እንቅስቃሴዎች ሰምተው ያውቃሉ? C. ኤሮቢክስ
(ከአንድ በላይ መልስ መስጠት ይችላሉ) D. ውሃ ዋና ወይም መዋኘት
E. የጉሌበትና እግር እንቅስቃሴ
F. ማፍታታት/አየር መውሰዴ
G. ሌላ ካለ(ይገለፅ)------------------------------
ጥ. 304 ከመጸነስዎ በፊት የአካል እንቅስቃሴ ሰርተው A. አዎ
ያውቃሉ? B. አላውቅም

ጥ. 305 ለጥያቄ ቁጥር 303 መልስዎ አዎ ከሆነ ምን A. የእለት ከለት ስራዎች ለምሳሌ ማብሰል፣ መጋገር
አይነት የአካል እንቅስቃሴ ሰርተወው B. መራመድ/የእገር ጉዞ ማድረግ (Walk)
ያውቃሉ? C. ኤሮቢክስ
D. ውሃ ዋና ወይም መዋኘት
E. ማፍታታት/አየር መውሰድ
F. ሩጫ
G. የጂም ስፖርት
H. ሌላ ካለ(ይገለፅ)------------------------------

ክፍል 4፡ የቅድመ ወሊድ የአካል እንቅስቃሴዎች ጠቀሜታ ላይ ያለ እውቀትን የተመለከቱ ጥያቄዎች

መመሪያ ለጠያቂው፡ አረፍተ ነገሩ ትክክል ከሆነ A ን ያክብቡ፣ትክክል ካልሆነ B ን ያክብቡ ፣ እርግጠኛ ካልሆኑ C ን ያክብቡ

56
ተ/ቁ ጥያቄዎች አማራጭ መልሶች

ጥ.401 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ

የጀርባ ህመምን ይቀንሳል፡፡ B. አይሆንም
C. አላውቅም
ጥ.402 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ
ከመጠን በላይ የክብደት መጨመርን B. አይሆንም
ይከላከላል፡፡ C. አላውቅም

ጥ.403 የአካል እንቅስቃሴ መስራት በምጥና ወሊድ A. አዎ

ወቅት የሚፈጠር ህመምን ይቀንሳል፡፡ B. አይሆንም
C. አላውቅም
ጥ.404 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ
በእርግዝና ጊዜ የሚከሰት የስኳር በሽታን B. አይሆንም
ይከላከላል/ይቀንሳል ፡፡ C. አላውቅም

ጥ.405 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ

ከፍተኛ ደም ግፊት እንዳይከሰት ይካላከላል፡፡ B. አይሆንም
C. አላውቅም
ጥ.406 የአካል እንቅስቃሴ መስራት የቅድመ ወሊድና A. አዎ
ድህረ ወሊድ ጭንቀትን ይከላከላል፡፡ B. አይሆንም
C. አላውቅም
ጥ.407 የአካል እንቅስቃሴ መስራት ከወሊድ በኋላ A. አዎ
ወዲያውኑ አቋምን ለማስተካከል ያግዛል፡፡ B. አይሆንም
C. አላውቅም
ጥ.408 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ
አጠቃላይ ለእናቶች እና ለህፃናት ጤና B. አይሆንም
ይጠቅማል፡፡ C. አላውቅም

ጥ.409 በአግባቡ ቁጥጥር ያልተደረገበት የስኳር በሽታ A. አዎ

1 ሲኖር በእርግዝና ወቅት የአካል እንቅስቃሴ B. አይሆንም
መስራት የተከለከለ ነው፡፡ C. አላውቅም

ጥ.410 ያለ ጊዜው ምጥ ሲፈጠር በእርግዝና ወቅት A. አዎ

57
 የአካል እንቅስቃሴ መስራት አያስፈልግም፡፡ B. አይሆንም
C. አላውቅም
ጥ.411 የእንሽርት ውሃ በሚፈስበት ጊዜ የአካል A. አዎ
እንቅስቃሴ መስራት አያስፈልግም፡፡ B. አይሆንም
C. አላውቅም
ጥ.412 በእርግዝና ጊዜ የሚከሰት የደም ግፊት A. አዎ
መጨመር ጊዜ የአካል እንቅስቃሴ መስራት B. አይሆንም
አያስፈልግም፡፡ C. አላውቅም

ክፍል 5፡ በእርግዝና ጊዜ ሰለሚደረጉ የአካል እንቅስቃሴ አመለካከት የሚመለከቱ ጥያቄዎች

ተ/ቁ ጥያቄዎች አማራጭ መልሶች

ጥ.501 በእርግዝና ወቅት የአካል እንቅስቃሴ መስራት A. አዎ

አስፈሊጊ ነው ብለው ያምናሉ? B. አይሆንም
C. አላውቅም
ጥ.502 በእርግዝና ወቅት አካላዊ እንቅስቃሴ ማድረግ A. አዎ
ህፃኑን ለአደጋ ያጋልጣል ብለው ያምናሉ? B. አይሆንም
C. አላውቅም
ጥ.503 የቅድመ ወሊድ የአካል እንቅስቃሴ ማድረግ A. አዎ
ከባህላቸን ጋር ይስማማል ብለው ያስባሉ? B. አይሆንም
C. አላውቅም
ጥ.504 የቅድመ ወሊድ የአካል እንቅስቃሴ ማድረግ A. አዎ
ከሃይማኖታችን ጋር ይስማማል ብለው B. አይሆንም
ያስባሉ? C. አላውቅም

ጥ.505 ነብሰጡር እናቶች በጤና ባለሙያዎች A. አዎ

በመታገዝ የአካል ብቃት እንቅስቃሴ ማድረግ B. አይሆንም
አለባቸው ብለው ያምናሉ? C. አላውቅም

ጥ.506 የቅድመ ወሊድ የአካል እንቅስቃሴ ማድረግ A. አዎ

ከእርግዝና ጋር የተዛመዱ ችግሮችን ሊቀንስ B. አይሆንም
ይችላል ብለው ያስባሉ? C. አላውቅም

58
ጥ.507 በእርግዝና ወቅት የአካል ብቃት እንቅስቃሴ A. አዎ
ማድረግ ከድህረ ወሊድ በኋላ መልሶ ለማገገም B. አይሆንም
ይረዳል ብለው ያስባሉ? C. አላውቅም

ጥ.508 በእርግዝና ወቅት የሚደረግ የአካል እንቅስቃሴ A. አዎ

ከአንዲት እናት ከሌለኛዋ እናት ይለያያል B. አይሆንም
ብለው ያስባሉ? C. አላውቅም

ስለ ተሳትፎዎ እናመሰግናለን!!!

59