الفهرس 
Health care system in LibyaOnly 14 pages are availabe for public view
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Abstract
According to the results of the current study, the following can be concluded:
1. The majority (85.3%) of the participant of the study subjects tended to have high level of knowledge.
2. Most of the pregnant women (96.0%) had positive attitude about antenatal care.
3. The highest percentage (85.8%) of the pregnant women who had high knowledge score about ANC, had positive attitude toward ANC. However, the association between knowledge score and their attitude was not statistically significant (p = 0.067).
4. The pregnant women who had high knowledge score about ANC, had good and average practices (86.9% and 81.9% respectively). The association between knowledge score and practices was found statistically significant (p = 0.047).
5. The pregnant women who had positive attitude about ANC, almost all (97.4%) had good practices, and 91.8% had an average level of practices. The association was found statistically insignificant (p = 0.088).
6. The level of overall knowledge of the women about ANC was significantly correlated with their practices during pregnancy (r = 0.228, p = < 0.001), while it was negatively correlated with their attitude (r = 0.029, p = 0.619).
7. The main source of knowledge were doctors (60%) followed by relatives and friends (25%).
8. More than half (54.7%) of the study sample were satisfied about the services of the primary health care centers.
9. The highest rates of the pregnant women who were scored as satisfied about ANC had high knowledge, positive attitude and good practices score (56.3%, 55.2% and 58.5% respectively). The association between women satisfaction and their knowledge and attitude were statistically insignificant except their practices (p = 0.012). Based on the results of the present study, the following recommendations are suggested:
I- Antenatal education:
Message of health education in the primary health care centers should include the following items:
• Pregnant women should be offered opportunity to attend antenatal classes and have written information about antenatal care.
• Pregnant women should not use any medication without physician prescription.
• Testing for birth defect or genetic diseases.
• Breastfeeding after pregnancy.
• Healthy behavior during pregnancy. e.g. (Adequate nutrition, Personal hygiene, Rest and sleep, Exercise….etc.)
• Initial visit and periodic visit.
• Warning signs and high risk pregnancy (vaginal bleeding, sever edema, decrease or cessation of fetal movement, hazards of negative smoking, mental health aspects….etc.)
The health education message should be more attention to female at rural area’s, premarital, young mother, non educated pregnant women and primigravida.
II- Mass media for antenatal education:
• Knowledge about healthy behavior during pregnancy should be diffused through mass media as television, radio, newspapers, magazines, pamphlets and posters. This should reinforce message given by health personnel about pregnancy and the important of antenatal follow up visits.
• Simple illustrative printed materials should be designed by specialized to meet pregnant women’s needs. Such printed materials should be made available to pregnant women at all antenatal clinics and maternal and child health centers.
III- Recommendations related services and government:
• All health personnel providing care to the pregnant women should be motivated to play their role in health education.
• Nurse midwives should be trained and encouraged to use the information guide as a good educational tool in counseling antenatal clients.
• On the national level, women should be empowered through better education and employment opportunities.
• Medical records, electronic or paper based should be developed.
• Government should establish more health centers in the rural areas so that pregnant women will have access to health facilities which will discourage them from going to tradition birth attendants for their treatment.
IV- Recommendations related further studies:
Further studies should be carried out to:
• Specific intervention program customized to the rural women need to be planned and conducted in order to improve their maternal health practices and eventually improve the health status of them.
• Elicit pregnant women opinion and level of satisfaction with the quality of care provided.
• Assess the satisfaction of the health care providers of ANC to investigate the causes of poor quality.